Multi-ethnic reference values for spirometry for the 3-95-yr age range: the global lung function 2012 equations

Area of Science:

• Pulmonary Medicine
• Global Health
• Biostatistics

Background:

• Spirometry is crucial for diagnosing respiratory diseases.
• Existing spirometric prediction equations often lack global applicability and diverse ethnic representation.
• The European Respiratory Society Global Lung Function Initiative aimed to address these limitations.

Purpose of the Study:

• To derive continuous, globally applicable spirometric prediction equations and their lower limits of normal.
• To establish reference equations for healthy non-smokers across various age groups and ethnicities.

Main Methods:

• Utilized over 160,000 spirometry data points from 72 centers in 33 countries.
• Applied the LMS method for simultaneous modeling of mean, coefficient of variation, and skewness.
• Derived reference equations for Caucasians, African-Americans, North Asians, and South East Asians aged 3-95 years.

Main Results:

• Established spirometric prediction equations for healthy individuals aged 3-95 years across four major ethnic groups.
• Found that Forced Expiratory Volume in 1 second (FEV1) and Forced Vital Capacity (FVC) differed proportionally between ethnic groups, while the FEV1/FVC ratio remained consistent.
• A composite equation was provided for individuals not represented by the primary groups.

Conclusions:

• Continuous spirometric prediction equations with age-dependent lower limits of normal are now available for global application.
• These equations facilitate more accurate interpretation of lung function across diverse populations.
• Future data collection from underrepresented regions will further enhance these global reference equations.