Evaluation of the global lung function initiative 2012 reference values for spirometry in a Swedish population sample

Area of Science:

• Pulmonary Medicine
• Respiratory Physiology
• Clinical Epidemiology

Background:

• Global Lung Function Initiative (GLI) 2012 reference values are widely adopted but lack validation in European adult populations.
• Previous studies have not assessed the applicability of GLI values for Swedish adults.

Purpose of the Study:

• To evaluate the appropriateness of GLI reference values for a healthy adult Caucasian Swedish population.
• To determine if GLI values accurately reflect lung function parameters in this demographic.

Main Methods:

• Spirometry data from 501 healthy non-smoking Caucasian adults in northern Sweden (2008-2013) were analyzed.
• Predicted GLI reference values and Z-scores were calculated for FEV1, FVC, and FEV1/FVC ratio.
• Prevalence of airway obstruction was assessed using the Lower Limit of Normal (LLN) criterion.

Main Results:

• Observed FEV1 and FVC values were lower than predicted GLI values, with greater discrepancies in women.
• Z-scores for lung function parameters were not perfectly centered on zero.
• The prevalence of airway obstruction was 9.4% in women and 2.7% in men, deviating from the expected 5%.

Conclusions:

• GLI reference values may lead to biased prevalence estimates of airway obstruction in Sweden, especially among women.
• The findings highlight the necessity of validating GLI reference values across different countries and populations.
• Further research is needed to refine reference values for diverse ethnic and geographic groups.