Application of Global Lung Function Initiative Global Spirometry Reference Equations across a Large, Multicenter Pulmonary Function Lab Population.
Application of Global Lung Function Initiative Global Spirometry Reference Equations across a Large, Multicenter Pulmonary Function Lab Population.
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全球肺功能倡议全球肺量测定参考方程在大型、多中心肺功能实验室人群中的应用。
DOI：
10.1164/rccm.202303-0613oc
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发表时间：
2024
影响因子：
24.7
通讯作者：
Niven,AlexanderS
中科院分区：
文献类型：
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作者：
Kanj,AmjadN;Scanlon,PaulD;Yadav,Hemang;Smith,WilliamT;Herzog,TylerL;Bungum,Aaron;Poliszuk,Daniel;Fick,Edward;Lee,AugustineS;Niven,AlexanderS
理论基础：全球肺功能倡议(GLI)全球肺活量测定参考方程式最近被推导出来，以提供“种族中立”的解释选项。从种族特定的GLI-2012过渡到GLI全球参考方程的影响尚不清楚。目标：描述使用GLI Global替代GLI-2012参考方程在不同种族和民族的人群中预测的肺功能测量变化的方向和大小。方法：在这项使用大型肺功能实验室数据库的多中心横断面研究中，109,447项肺活量测定使用GLI全球参考方程重新分析，并与现有的GLI-2012标准进行比较，按自我报告的种族和民族分层。测量和主要结果：预测的平均FEV1和FVC百分比在白人和东北亚群体中增加，在黑人、东南亚和东北亚群体中减少和混合/其他种族群体。在白人组中，梗阻的患病率增加了9.7%，在黑人和东南亚组中，可能限制的患病率分别增加了51.1%和37.1%。在所有五个种族和民族群体具有相同代表性的人群中，使用GLI Global改变了10.2%的肺活量测定测试的解释类别。自我确认为黑人的受试者是唯一一组肺功能测试结果异常频率相对增加的人群(32.9%)。结论：GLI全球参考方程的使用将显著影响肺功能测试的解释。尽管GLI Global提供了一种从种族特定参考方程过渡的创新方法，但重要的是认识到继续需要将这些数据放在适当的临床环境中。
Rationale:Global Lung Function Initiative (GLI) Global spirometry reference equations were recently derived to offer a “race-neutral” interpretation option. The impact of transitioning from the race-specific GLI-2012 to the GLI Global reference equations is unknown.Objectives:Describe the direction and magnitude of changes in predicted lung function measurements in a population of diverse race and ethnicity using GLI Global in place of GLI-2012 reference equations.Methods:In this multicenter cross-sectional study using a large pulmonary function laboratory database, 109,447 spirometry tests were reanalyzed using GLI Global reference equations and compared with the existing GLI-2012 standard, stratified by self-reported race and ethnicity.Measurements and Main Results:Mean FEV1and FVC percent predicted increased in the White and Northeast Asian groups and decreased in the Black, Southeast Asian, and mixed/other race groups. The prevalence of obstruction increased by 9.7% in the White group, and prevalences of possible restriction increased by 51.1% and 37.1% in the Black and Southeast Asian groups, respectively. Using GLI Global in a population with equal representation of all five race and ethnicity groups altered the interpretation category for 10.2% of spirometry tests. Subjects who self-identified as Black were the only group with a relative increase in the frequency of abnormal spirometry test results (32.9%).Conclusions:The use of GLI Global reference equations will significantly impact spirometry interpretation. Although GLI Global offers an innovative approach to transition from race-specific reference equations, it is important to recognize the continued need to place these data within an appropriate clinical context.