Chronic obstructive pulmonary disease and risk of digestive diseases: observational and mendelian randomization analyses in the China Kadoorie Biobank

作者：Y ZHAO, Yalei Ke, D J Y Sun, P Pei, Ling Yang, Iona Y. Millwood, Robin G. Walters, Yuehua Chen, H D Du, J S Chen, Z M Chen, Jun Lv, Li Li, Canqing Yu, the China Kadoorie Biobank Collaborative Group, Robert Clarke, Rory Collins, Richard Peto, Daniel Avery, Maxim Barnard, Derrick Bennett, Ruth Boxall, Z M Chen, Johnathan Clarke, Ahmed Edris Mohamed, Hannah Fry, Prapthi Harish, Pek Kei Im, Andri Iona, Christiana Kartsonaki, Kshitij Kolhe, Hubert Lam, Kuang Lin, James Liu, Sam Morris, Qunhua Nie, Alfred Pozarickij, Maryanm Rahmati, Paul Ryder, Maruf Sarder, Dan Schmidt, Becky Stevens, Iain Turnbull, Baihan Wang, L M Wang, Neil Wright, Xiaoming Yang, Pang Yao, D J Y Sun, Yuanjie Pang, Yuting Han, Can Hou, Qingmei Xia, Chao Liu, Lang Pan, Xiao Han, Honglu Bian, X W Chen, Zengchang Pang, Ruqin Gao, Kunzheng Lv, Shanpeng Li, Haiping Duan, S Y Wang, Yongmei Liu, Ranran Du, Liang Cheng, Xiaocao Tian, Hua Zhang, Dan Hu, Xiaoyan Zheng, Yujie Wan, Wei Sun, Shichun Yan, Yong Zhou, Ce Wang, Zhenyuan Wu, Lishun Zhai, Zhaoxi Pang, Shiwen Dong, Li Liu, Dapeng Yin, Bin He, Ying Liu, Xingren Wang, Tingting Ou, Xiangyang Zheng, Dewei Zheng, Shuai Yang, Li Li, Xingjiao Chen, Yan Xu, Jinyi Zhou, Ran Tao, Jian Su, Xikang Fan, X W Chen, Yuxiao Huang, Yan Lu, Yujie Hua, X H Li, S Y Wang, Jianrong Jin, Juping Ma, Kaifei Zhu, Hongfu Ren, Xingfeng Shen, Ge Zhong, Wei Mao, Zhenzhen Lu, Yanxu Zhong, Lifang Zhou, Rong Pan, Jian Lan, Xiaoping Tan, Jinxue Tan, Yishan Xie, Liuping Wei, Liyuan Zhou, S Y Wang, Xianping Wu, Ningmei Zhang, X W Chen, Xiaoyu Chang, Z Wang, Yujin He, Mingqiang Yuan, L M Wang, Z Wang, Qiang Sun, Yang Lin, Faqing Chen, X Y Ren, Lijun Chang, Feiming Zhong, Jianjun Feng, Weijie Hu, Xiaofang Zhang, Yuehua Chen, Honghong Wang, Yi-Xiang Wang, Linqi Diao, Zhiwei Han, Dengjun Zhu, Kai Kang, Shixian Feng, Wenjie Yang, Huizi Tian, Yali Yan, Bing Han, Li Gao, Shaofang Li, Tianfang Xing, Wei Tang, X H Li, Huarong Sun, Xiaocong Zhao, Chen Hu, He Pan, Xukui Zhang, Jin Yuanyuan, Lan Luo, Min Yu, Ruying Hu, Hao Wang, Weiwei Gong, Jieming Zhong, Meng Wang, Chunxiao Xu, Ke Gong, Hu Xu, Yuan Cao, Kaixu Xie, Le Chen, Xiaomei Tu, Junlong Pan, X H Li, Li Yin, Huilin Liu, Yuan Liu, Lei Yin, Xian Xie, Yi-Xiang Wang, Bo Xiao, Zongwei Deng, Yuan Peng, Libo Zhang, Chan Qu, Li Deng, Qili Jiang, Yuehua Chen, J S Chen, Z M Chen, Li Li, Jun Lv, Robin G. Walters, Yuehua Chen, H D Du, Iona Millwood, Ling Yang, P Pei, C Q Yu, Ying Li · 发表于：Respiratory Research · 年份：2026 · DOI：10.1186/s12931-026-03825-w · 研究领域：Genetic Associations and Epidemiology、Chronic Obstructive Pulmonary Disease (COPD) Research、Glutathione Transferases and Polymorphisms

BACKGROUND: Several digestive diseases have been reported as comorbidities of COPD. However, consistent evidence supporting their associations is limited. Our study aims to investigate the associations between prevalent COPD and incident digestive diseases in the Chinese population. METHODS: We used data from the China Kadoorie Biobank (CKB), enrolling 512,724 participants aged 30-79 years at baseline from 10 areas in China. COPD was defined by spirometry (without bronchodilator) and self-reported emphysema/chronic bronchitis at baseline. We employed stratified Cox proportional regression models to assess the prospective associations of prevalent COPD and airflow obstruction severity with the risks of incident digestive diseases. A total of 31 digestive diseases were included, including the overall digestive diseases, 15 major disease categories, and 15 specific subtypes nested within the major categories. We further conducted one-sample Mendelian randomization analyses to assess the associations of genetically predicted COPD with digestive diseases. RESULTS: During a median follow-up of 15.3 years, a total of 131,993 participants experienced at least one hospitalization or death due to the included digestive diseases. For the composite outcome and major categories, prevalent COPD at baseline was significantly associated with a higher risk of overall digestive diseases (hazard ratio and 95% confidence interval: 1.05 [1.03-1.08]), gastrointestinal inflammation (1.11 [1.07-1.15...