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Interpretative consequences of adopting the Global Lungs 2012 reference equations for spirometry for children and

Philip H Quanjer1, Daniel J Weiner

  • 1Department of Pulmonary Diseases and Department of Paediatrics, Erasmus Medical Centre, Erasmus University, Rotterdam, The Netherlands.

Pediatric Pulmonology
|October 12, 2013
PubMed

Insights

The Global Lungs 2012 (GLI-2012) spirometric prediction equations show similar results to older methods for FEV1, FVC, and FEV1/FVC. This transition impacts the prevalence rates of abnormal lung function values.

Area of Science:

  • Pulmonary Medicine
  • Pediatric Respiratory Health
  • Diagnostic Spirometry

Background:

  • Spirometric prediction equations are crucial for diagnosing lung diseases in children.
  • The Global Lungs 2012 (GLI-2012) equations offer updated reference values.
  • Assessing the impact of adopting new equations is essential for clinical practice.

Purpose of the Study:

  • To evaluate the interpretative differences when using GLI-2012 spirometric equations compared to established ones.
  • To determine the effect on lung function classifications in a pediatric hospital setting.

Main Methods:

  • Analyzed spirometric data from 2,192 boys and 1,842 girls (white) and 412 boys and 334 girls (African-American), aged 6-18 years.
  • Calculated predicted values and lower limits of normal (LLN) for FEV1, FVC, and FEV1/FVC using GLI-2012, Hankinson, Knudson, Polgar, Wang, and Zapletal equations.
  • Defined obstruction and restrictive patterns based on FEV1/FVC and FVC relative to LLN.

Main Results:

  • GLI-2012, Hankinson, and Wang equations showed good agreement for predicted values within ethnic groups.
  • A near-normal FEV1 with above-normal FVC led to low FEV1/FVC, especially in African-Americans.
  • Restrictive patterns occurred in 2.2-11.2% of cases, with no significant difference between GLI-2012 and Hankinson.

Conclusions:

  • Adopting GLI-2012 equations results in similar prevalence rates of abnormal FEV1, FVC, and FEV1/FVC compared to Hankinson and Wang.
  • Significant discrepancies in results were observed with Knudson, Polgar, and Zapletal equations.
  • The transition to GLI-2012 is generally comparable to current widely used equations, unlike older, less consistent ones.
Abstract

Keywords:
airway obstructioninterpretive strategymisclassificationreference equationsspirometry

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