Global Lung Initiative 2012 spirometry reference values in a large Asian cohort of Malay, Chinese and Indian ancestry (original) (raw)
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European Respiratory Journal
BackgroundThere is little data to accurate interpretation of spirometry data in South Asia, a major global region with high reported burden for chronic respiratory disease.MethodWe measured lung function in 7,453 healthy men and women aged over 18 years, from Bangladesh, North India, South India, Pakistan and Sri Lanka, as part of the South Asia Biobank study. We first assessed the accuracy of existing equations for predicting normal forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and FEV1/FVC ratio. We then used our data to derive (N=5589) and internally validate (N=1864) new prediction equations amongst South Asians, with further external validation amongst 339 healthy South Asians living in Singapore.ResultsGLI2012 and NHANESIII consistently overestimated expiratory volumes (best fit GLI-African American, mean [sd] z-score (n=7453): FEV1 −0.94 [1.05]; FVC −0.91 [1.10]). Age, height and weight were strong predictors of lung function in our participants (p<0...
European Respiratory Journal
BackgroundThere are few data to support accurate interpretation of spirometry data in South Asia, a major global region with a high reported burden of chronic respiratory disease.MethodWe measured lung function in 7453 healthy men and women aged ≥18 years, from Bangladesh, North India, South India, Pakistan and Sri Lanka, as part of the South Asia Biobank study. First, we assessed the accuracy of existing equations for predicting normal forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and FEV1/FVC ratio. Then, we used our data to derive (n=5589) and internally validate (n=1864) new prediction equations among South Asians, with further external validation among 339 healthy South Asians living in Singapore.ResultsThe Global Lung Initiative (GLI) and National Health and Nutrition Examination Survey consistently overestimated expiratory volumes (best fit GLI-African American, mean±sdz-score: FEV1−0.94±1.05, FVC −0.91±1.10; n=7453). Age, height and weight were strong p...
Challenges in Collating Spirometry Reference Data for South-Asian Children: An Observational Study
PloS one, 2016
Spirometry datasets from South-Asian children were collated from four centres in India and five within the UK. Records with transcription errors, missing values for height or spirometry, and implausible values were excluded(n = 110). Following exclusions, cross-sectional data were available from 8,124 children (56.3% male; 5-17 years). When compared with GLI-predicted values from White Europeans, forced expired volume in 1s (FEV1) and forced vital capacity (FVC) in South-Asian children were on average 15% lower, ranging from 4-19% between centres. By contrast, proportional reductions in FEV1 and FVC within all but two datasets meant that the FEV1/FVC ratio remained independent of ethnicity. The 'GLI-Other' equation fitted data from North India reasonably well while 'GLI-Black' equations provided a better approximation for South-Asian data than the 'GLI-White' equation. However, marked discrepancies in the mean lung function z-scores between centres especially...
Normal spirometry predictive values for the Western Indian adult population
European Respiratory Journal, 2020
Interpretation of spirometry involves comparing lung function parameters with predicted values to determine the presence/severity of the disease. The Global Lung Function Initiative (GLI) derived reference equations for healthy individuals aged 3–95 years from multiple populations but highlighted India as a “particular group” for whom further data are needed. We aimed to derive predictive equations for spirometry in a rural Western Indian adult population.We used spirometry data previously collected (2008–2012) from 1258 healthy adults (aged 18 years and over) by the Vadu Health and Demographic Surveillance System. We constructed sex-stratified prediction equations for forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FEV1/FVC using the Generalised Additive Model for Location, Scale and Shape (GAMLSS) method to derive the best fitting model of each outcome as a function of age and height.When compared with GLI Ethnicity Codes 1 (White Caucasian) and 5 (Other/M...
Pakistan journal of medical sciences
Lung function tests are essential for the diagnosis and management of different respiratory tract diseases; among them the spirometry is the gold standard technique. The accurate diagnosis, management and monitoring require proper interpretation of the results which depends upon the availability of spirometry reference data for that particular region to differentiate the diseased condition from the normal ones. Multiple studies had been done to find out their own area specific reference ranges but it is still lacking. This need was fulfilled by the Global Lung Function Initiative (GLI) in 2012, which reported the first global spirometry equation for all of the age groups. But some of the studies reported difference among GLI reference range and the measured range for that particular region. So here is the review of the reference ranges among 35,603 Asian children and adolescents from the 32 studies done specifically in Asia. The aim was to compare them with the study done by GLI tea...
2012
This study includes data from the MESA study, Funded by National Institutes of Health R01-HL077612, N01-HC095159-165, N01-HC095169. 4.1. Representativeness of equations for various groups 4.2. Data quality 4.3. Secular trends 4.4. Age related trends in FEV 1 and FVC 4.5. Mixed ethnic descent 4.6. Application in clinical practice 4.7. Clinical decision making 4.8. Strengths and weaknesses 4.9. Future developments 5. CONCLUSIONS 6. RECOMMENDATIONS References ABSTRACT Objective: Derive continuous prediction equations and their lower limits of normal for spirometric indices, which are applicable globally. Material: Over 160,000 data points from 72 centres in 33 countries were shared with the European Respiratory Society Global Lung Function Initiative. Eliminating data that could not be used (mostly missing ethnic group, some outliers) left 97,759 records of healthy nonsmokers (55.3% females) aged 2.5-95 years. Methods: Lung function data were collated, and prediction equations derived using the LMS (λ, µ, σ) method, which allows simultaneous modelling of the mean (mu), the coefficient of variation (sigma) and skewness (lambda) of a distribution family. Results: After discarding 23,572 records, mostly because they could not be combined with other ethnic or geographic groups, reference equations were derived for healthy individuals from 3-95 years for Caucasians (N=57,395), African Americans (N=3,545), and North (N=4,992) and South East Asians (N=8,255). FEV 1 and FVC between ethnic groups differed proportionally from that in Caucasians, such that FEV 1 /FVC remained virtually independent of ethnic group. For individuals not represented by these four groups, or of mixed ethnic origins, a composite equation taken as the average of the above equations is provided to facilitate interpretation until a more appropriate solution is developed. Conclusion: Spirometric prediction equations for the 3-95 age range are now available that include appropriate age-dependent lower limits of normal. They can be applied globally to different ethnic groups. Additional data from the Indian subcontinent, Arab, Polynesian, Latin American countries, and Africa will further improve these equations in the future.
Normative spirometric values in adult kashmiri population
2012
Background. Normative values of pulmonary functions of healthy population are affected by different geographic, ethnic, climatic and demographic factors. Objective. Present study was designed to derive normative spirometric values, prediction equations for future reference in adult Kashmiri population. Methods. Pulmonary function testing was carried out on 3080 normal healthy non-smoking individuals (1974 males; age 18-65 years) of Kashmir valley. Multiple regression analysis was used to develop prediction equations for use in this population. Results. Forced vital capacity (FVC, L/s) (4.3±0.8 versus 3.0±0.5; p<0.05), forced expiratory volume in the first second (FEV1, L/s) (3.9±0.7 versus 2.6±0.5; p<0.05) and peak expiratory flow rate (PEFR, L/s) (7.9±1.8 versus 5.3±1.2; p<0.05) were significantly higher in males in comparison with females. All the other parameters except FEV1/PEFR ratio were significantly higher among males (p<0.05). Irrespective of gender, all the par...
Spirometric Reference Values for an East-African Population
Respiration, 2013
Background: Accurate interpretation of lung function testing requires appropriate reference values. Unfortunately, few African countries have produced spirometric reference values for their populations. Objectives: The present study was carried out in order to establish normal lung function values for subjects living in Rwanda, East Africa. Methods: The study was conducted in Kigali, capital of Rwanda, and in the rural district of Huye in southern Rwanda. The variables studied were forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and peak expiratory flow. Multiple regression analysis was performed using age, height, weight and BMI as independent variables to obtain predicted equations for both sexes. Results: Predicted equations for normal lung functions were obtained from 740 healthy nonsmoking subjects; 394 were females and 346 were males. Minor differences in FEV1 and FVC were observed in comparison with other studies of Africans, African-Americans (difference ...
SPIROMETRY AND FLOW-VOLUME CURVES IN HEALTHY, NORMAL PAKISTANIS
Previous studies have indicated that lung volumes in healthy, normal Pakistani adults are smaller than measurements reported in comparable healthy European populations; in order to confirm these findings and to examine the relationship of maximal expiratory flow rates to lung volumes, we studied 250 non-smoking healthy subjects (116 men and 114 women) between the ages of 18 and 6.5 years. The population sample was drawn from urban and rural areas of Pakistan, with low levels of air pollution. The results indicate that the forced vital capacity (FVC) and forced expired volume in 1 second (FEV,) were lower in the Pakistani population compared to European populations and North American populations of European descent. These data are in conformity with previous studies; however, in Pakistani men the effects of age on FVC and FEV, were slight so that, after the fourth decade, the FVC and FEV, values are very comparable between the European and Pakistani populations. Amongst Pakistani women, on the other hand, FVC and FEV, remained lower than in their European counterparts throughout adult life. Maximal expiratory flow rates amongst the men did not correlate with age, and these values were very similar to those reported in age-matched European populations. In women, however, there was a significant correlation of maximal flow rates with age and height, and the maximal expiratory flows were decreased compared to European populations. These data indicate that in Pakistani men pulmonary mechanics may be different to their European counterparts, allowing for higher maximal expiratory flows at any given lung volume.