To investigate the heterogeneity of early chronic obstructive pulmonary disease (COPD) and its influencing factors among residents aged 40 years old or above in Shijingshan district of Beijing.

Data of 4096 people from the 2019 Shijingshan COPD screening program were retrospectively analyzed, of which 377 had preserved ratio impaired spirometry (PRISm), 349 had pre-COPD, and 199 had mild COPD. The prevalence, epidemiological and clinical features, and influencing factors of the three types of early COPD conditions were analyzed.

The prevalence of PRISm, pre-COPD, and mild COPD in the general population was 9.2% (95% confidence interval: 8.3~10.1), 8.5% (7.7~9.4), and 4.9% (4.2~5.5), respectively. PRISm and pre-COPD patients were more often influenced by established personal factors. In contrast, patients with mild COPD were more often exposed to environmental factors such as harmful gases, particulate matter, or infections. All three early COPD conditions showed a more severe symptom burden compared to controls, and more than 50% of patients with each of the three early COPD conditions had small airway dysfunction. Overall, gender and body mass index were associated with the development of the three early COPD conditions; older age, lower education level, lower economic income, smoking history, more cumulative cigarette exposure, passive smoke exposure, history of bronchitis or pneumonia in childhood, parental history of respiratory diseases, and being comorbid with cardiovascular disease were all associated with increased presence of the three early COPD conditions. Besides, only 22.2% of the participants had ever underwent pulmonary function test, only 36.4% knew COPD, and less than 4% had ever been diagnosed with COPD previously.

Significant heterogeneity exists in the prevalence, epidemiological and clinical features, and influencing factors of early COPD conditions among residents aged 40 years old or above in Shijingshan district of Beijing. However, the relevant studies are obviously insufficient, and further studies based on large samples and standardized populations are still needed to provide a theoretical basis for early prevention, diagnosis, and treatment of early COPD.