Performance of American Thoracic Society-Recommended Spirometry Reference Values in a Multiethnic Sample of Adults The Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study
Performance of American Thoracic Society-Recommended Spirometry Reference Values in a Multiethnic Sample of Adults The Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study
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DOI：
10.1378/chest.09-0919
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发表时间：
2010-01-01
期刊：
影响因子：
9.6
通讯作者：
Barr, R. Graham
中科院分区：
文献类型：
--
作者：
Hankinson, John L.;Kawut, Steven M.;Barr, R. Graham
背景资料：美国胸科学会建议使用国家健康与营养调查（NHANES）III中的种族特异性肺功能参考值对美国白人、非洲裔美国人和墨西哥裔美国人的肺功能进行临床评价，亚裔美国人的校正因子为0.94。我们的目的是验证的NHANES III参考方程和校正因子为亚裔美国人在一个独立的，多种族的美国adultes.Methods样本：多种族研究的动脉粥样硬化（梅萨）招募自我认定的非西班牙裔白色，非洲裔美国人，西班牙裔和亚裔美国人的参与者，年龄在45至84岁，在六个美国网站。MESA-肺研究评估了3，893名梅萨参与者的支气管扩张剂前肺功能测定，这些参与者进行了可接受的测试，其中1，068名为无症状健康非吸烟者，进行了可接受的肺功能测定。结果：1，068名参与者平均年龄65 ± 10岁，60%为女性，25%为白色，20%为非洲裔美国人，23%为西班牙裔美国人，32%为亚裔美国人。MESA-Lung中白人、非裔美国人和墨西哥裔西班牙人的FEV 1、FEV 6和FVC观察值略低于基于NHANES III的预测值。在非墨西哥血统的西班牙裔人中观察到的数值一直较低。根据正常标准下限，气流阻塞参与者的分类一致性良好（总体kappa = 0.88）。对于亚裔美国人，校正因子0.88比0.94更准确。结论：NHANES III参考方程适用于白色、非洲裔美国人或墨西哥裔西班牙裔老年人。比较白色和亚裔美国人参与者表明，应用于正常值的预测值和下限的校正因子0.88比目前推荐的0.94更合适。胸部2010; 137（1）：138-145
Background: The American Thoracic Society recommends race-specific spirometric reference values from the National Health and Nutrition Survey (NHANES) III for clinical evaluation of pulmonary function in whites, African-Americans, and Mexican-Americans in the United States and a correction factor of 0.94 for Asian-Americans. We aimed to validate the NHANES III reference equations and the correction factor for Asian-Americans in an independent, multiethnic sample of US adults.Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) recruited self-identified non-Hispanic white, African-American, Hispanic, and Asian-American participants aged 45 to 84 years at six US sites. The MESA-Lung Study assessed prebronchodilator spirometry among 3,893 MESA participants who performed acceptable tests, of whom 1,068 were asymptomatic healthy nonsmokers who performed acceptable spirometry.Results: The 1,068 participants were mean age 65 +/- 10 years, 60% female, 25% white, 20% African-American, 23% Hispanic, and 32% Asian-American. Observed values of FEV1, FEV6, and FVC among whites, African-Americans, and Hispanics of Mexican origin in MESA-Lung were slightly lower than predicted values based on NHANES III. Observed values among Hispanics of non-Mexican origin were consistently lower. Agreement in classification of participants with airflow obstruction based on lower limit of normal criteria was good (overall kappa = 0.88). For Asian-Americans, a correction factor of 0.88 was more accurate than 0.94.Conclusions: The NHANES III reference equations are valid for use among older adults who are white, African-American, or Hispanic of Mexican origin. Comparison of white and Asian-American participants suggests that a correction factor of 0.88, applied to the predicted and lower limits of normal values, is more appropriate than the currently, recommended value of 0.94. CHEST 2010; 137(1):138-145