Reference values for 6‐min walk distance in Asian adults may not be different from that of Caucasian adults
Reference values for 6‐min walk distance in Asian adults may not be different from that of Caucasian adults
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DOI：
10.1111/j.1440-1843.2006.00914.x
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发表时间：
2006-09
期刊：
影响因子：
6.9
通讯作者：
S. Teramoto;H. Kume;T. Ishii;Hiroshi Yamamoto;Y. Yamaguchi;M. Ishii;Y. Hanaoka;Y. Ouchi
中科院分区：
文献类型：
--
作者：
S. Teramoto;H. Kume;T. Ishii;Hiroshi Yamamoto;Y. Yamaguchi;M. Ishii;Y. Hanaoka;Y. Ouchi
在最近一期的《呼吸学》杂志上，Poh及其同事证明，健康新加坡成年人的6分钟步行距离（6MWD）不能使用来自高加索人群的参考方程来预测。已发表的白人受试者方程高估了新加坡华人的6MWD。1这是一项非常重要的研究，将有助于解释亚洲心肺疾病患者的6MWD，因为6MWD参考值大多是针对健康白人受试者发表的。我们同意作者的观点，即亚洲人群的适当参考值对于评估中老年COPD患者的身体功能是必要的。然而，作者没有全面审查已发表的关于日本人6MWD参考值的研究。2，3 10分钟步行距离（10MWD）测试由日本慢性呼吸衰竭研究小组开发，用于确定日本健康男性和女性成年人的10MWD参考值。2根据这些值，健康日本男性和女性的平均6MWD值分别约为572 m和504 m。158名健康受试者也使用标准化方案进行了三次步行试验，以评估6MWD。日本健康男性和女性成年人的6MWD平均值分别为624 m和541 m。这些数据与作者的数据或Enright和Sherrill的数据并没有太大的不同。4因此，我们不认为参考值显示亚洲人和高加索人人群之间存在很大差异（表1）。此外，即使在高加索人群中，6MWD参考值也存在相当大的差异。Enright及其同事报告称，使用心血管健康研究的样本，健康参与者亚组的平均6MWD为老年女性367 m，老年男性400 m。[5]对于平均身高和体重的67岁白色女性和男性，该方程预测的距离分别为430米和464米。该参考方程给出的预测（平均）6MWD远低于之前研究者发表的高加索人群的预测值。6-8 Troosters及其同事报告称，健康老年男性和女性的6MWD平均值分别为673 m和589 m。6一项针对美国图森市290名健康成年人的研究预测，女性和男性的距离分别为466米和544米。Rikli和Jones在7183名老年人中检查了6MWD。他们的预测值大约比Enright的数据大50%。[7]这些参考方程在高加索人和亚洲人的健康志愿者中如此不同的原因尚不清楚。受试者招募和测试说明的差异可能是不同研究之间差异的原因。美国胸科协会已经发布了详细的6MWD程序指南，研究人员应该遵循这些指南，研究仔细选择的健康人。[8]还应注意的是，从该模型中获得的参考方程仅解释了6MWD中20%的变化。5根据美国胸科学会对先前发表的6MWD研究的回顾，由于学习效应的增加范围从0到17%。在一周内进行两次测试后，性能通常会达到平台。一项对112名稳定的重度COPD患者进行的研究的再现性结果表明，干预后6MWD改善> 70 m对于95%置信度的显著改善是必要的。9、与……
In a recent issue of Respirology, Poh and coworkers demonstrated that the 6-min walk distance (6MWD) in healthy Singaporean adults cannot be predicted using the reference equations derived from Caucasian populations. Published equations derived from Caucasian subjects overestimated 6MWD in Singaporean Chinese. 1 This is very important research that will assist in the interpretation of 6MWD in Asian patients with cardiopulmonary disease, as the 6MWD reference values have mostly been published for healthy Caucasian subjects. We agree with the authors that an adequate reference value for Asian peoples is necessary for assessing physical function in middleaged and older patients with COPD. However, the authors did not fully review the published studies on the 6MWD reference values in Japanese people. 2, 3 The 10-min walk distance (10MWD) test was developed by the Japanese Research Group for Chronic Respiratory Failure to determine the 10MWD reference values for healthy male and female Japanese adults. 2 From these values, the mean 6MWD value for healthy Japanese men and women are approximately 572 m and 504 m, respectively. One hundred and fifty-eight healthy subjects were also evaluated for 6MWD using three walking tests with a standardized protocol. Mean values of 6MWD for healthy male and female Japanese adults are 624 m and 541 m, respectively. These data are not all that different from the authors’ data or from Enright and Sherrill’s data. 4 As such we do not think that the reference values show a big difference between Asian and Caucasian populations (Table 1). Moreover, there are considerable variations of 6MWD references even in the Caucasian population. Enright and coworkers have reported that the mean 6MWD in a healthy subset of participants was 367 m for elderly women and 400 m for elderly men using a sample from the Cardiovascular Health Study. 5 The equations predict distances of 430 m and 464 m for a 67-year-old white woman and man of average height and weight, respectively. This reference equation gives predicted (mean) 6MWDs that are substantially lower than those published by previous investigators on Caucasian populations. 6–8 Troosters and coworkers have reported that the mean values for 6MWD for healthy elderly men and women are 673 m and 589 m, respectively. 6 A study of 290 healthy adults in Tucson, USA predicts distances of 466 m and 544 m for women and men, respectively. 4 Rikli and Jones have examined 6MWD in 7183 older adults. Their predicted values are approximately 50% greater than Enright’s data. 7 The reasons why these reference equations are so different in healthy volunteers in either Caucasian or Asians are not clear. Differences in participant recruitment and test instructions may account for the variations among different studies. The American Thoracic Society has published detailed guidelines for 6MWD procedures that should be followed by investigators studying carefully selected healthy people. 8 It has been also cautioned that the reference equations obtained from this model explained only 20% of the variation in 6MWD. 5 According to the American Thoracic Society review of previously published 6MWD studies, the increases due to the learning effect ranged from a mean of zero to 17%. Performance usually reaches a plateau after two tests performed within a week. The reproducibility results from one study of 112 patients with stable, severe COPD suggest that an improvement of> 70 m in the 6MWD after an intervention is necessary to be 95% confident that the improvement was significant. 9 Considered together with the …