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Author Spotlight: Integrating Alveolar-Capillary Reserve Measurements in Exercise Adaptation and Therapeutic Strategies
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Referential equations for pulmonary diffusing capacity using GAMLSS models derived from Japanese individuals with

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  • 1First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.

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New reference values for lung diffusing capacity (DLCO), alveolar volume (VA), and transfer coefficient (KCO) were generated for the Japanese population. These new values are more appropriate than existing GLI-2017 standards, improving lung function assessment.

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Area of Science:

  • Pulmonary Medicine
  • Respiratory Physiology
  • Clinical Diagnostics

Background:

  • Accurate reference values for lung function tests are crucial for diagnosing respiratory diseases.
  • Existing global reference values may not accurately reflect specific populations, necessitating localized data.

Purpose of the Study:

  • To establish precise reference values for single-breath diffusing capacity of the lungs for carbon monoxide (DLCO), alveolar volume (VA), and transfer coefficient (KCO) in the Japanese population.
  • To evaluate the suitability of these new values compared to the Global Lung Function Initiative 2017 (GLI-2017) and prior equations.

Main Methods:

  • Retrospective analysis of spirometric indices, DLCO, VA, and KCO in 390 Japanese individuals aged 16-85 years.
  • Utilized the lambda, mu, and sigma (LMS) method and generalized additive models (GAM) for reference value generation.

Main Results:

  • Generated reference values showed lower mean square errors for DLCO, VA, and KCO compared to GLI-2017 and previous linear regression equations.
  • GLI-2017 z-scores indicated approximate zero for DLCO but significant deviations for KCO and VA in the Japanese cohort.

Conclusions:

  • The reference values derived in this study are more appropriate for the Japanese population than GLI-2017.
  • GLI-2017 appears to underestimate KCO and overestimate VA in Japanese individuals, highlighting the need for population-specific lung function data.