Reference equations for spirometry in healthy Asian children aged 5 to 18 years in Taiwan

Area of Science:

• Pediatric Pulmonology
• Respiratory Physiology
• Biostatistics

Background:

• Spirometry is crucial for assessing lung function in children.
• Existing reference equations, like GLI-2012, may not accurately represent diverse pediatric populations.
• Establishing population-specific equations is vital for accurate diagnosis and management.

Purpose of the Study:

• To establish new spirometry reference equations for healthy Taiwanese children aged 5-18 years.
• To evaluate the accuracy of the Global Lung Function Initiative (GLI)-2012 equations in this cohort.
• To compare different statistical modeling approaches for deriving these equations.

Main Methods:

• Collected spirometric data from 757 healthy Taiwanese children (ages 5-18).
• Derived prediction equations using linear regression and Generalized Additive Models for Location, Scale and Shape (GAMLSS).
• Assessed the fit of derived equations and GLI-2012 equations against the collected data.

Main Results:

• GLI-2012 South East Asian equations showed poor agreement with Taiwanese children's spirometric data (z-scores deviated significantly).
• GAMLSS models, incorporating age, height, and weight, provided a close fit to the study population's spirometric characteristics.
• GAMLSS models outperformed both linear regression and GLI-2012 equations in capturing data patterns.

Conclusions:

• This study presents updated spirometry reference values for Taiwanese children using GAMLSS modeling.
• The GLI-2012 reference equations are not well-matched to contemporary Taiwanese children, necessitating revisions.
• There is an urgent need to update GLI reference values with more diverse, non-Caucasian data.