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Related Experiment Video

Updated: Jul 16, 2025

Author Spotlight: Integrating Alveolar-Capillary Reserve Measurements in Exercise Adaptation and Therapeutic Strategies
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Referential equations for pulmonary diffusing capacity generated from the Japanese population using the Lambda, Mu,

Masayuki Hanaoka1, Yosuke Wada1, Norihiko Goto1

  • 1First Department of Internal Medicine, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, Nagano 390-8621, Japan.

Respiratory Investigation
|September 14, 2023
PubMed
Summary

This study developed new reference equations for lung function tests in Japan. These equations provide more accurate predictions for diffusing capacity than existing global standards.

Keywords:
Pulmonary diffusing capacityPulmonary function testPulmonologyReference valuesTransfer coefficient of the lungs for carbon monoxide

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Area of Science:

  • Pulmonary Medicine
  • Respiratory Physiology
  • Biostatistics

Background:

  • Accurate reference equations are crucial for interpreting pulmonary function tests.
  • Existing prediction equations may not accurately reflect diverse populations, including the Japanese population.
  • This study addresses the need for population-specific reference values for lung diffusing capacity.

Purpose of the Study:

  • To establish new reference equations for single-breath lung carbon monoxide diffusing capacity (DLCO), alveolar volume (VA), and transfer coefficient of the lungs for carbon monoxide (KCO) in the Japanese population.
  • To compare the accuracy of newly developed equations with existing Global Lung Initiative (GLI) and linear regression equations.

Main Methods:

  • Prospective and retrospective collection of pulmonary function data from healthy volunteers and patients aged 16-85 years.
  • Utilized a generalised additive model for location size and shape (GAMLSS) to construct the prediction equations.
  • Validated the new equations against existing prediction models using root mean square error (RMSE).

Main Results:

  • 702 pulmonary function tests were analyzed.
  • The newly developed prediction equations demonstrated lower RMSEs for DLCO, VA, and KCO compared to GLI and previous linear regression equations.
  • Significant discrepancies were observed between GLI baseline prediction equations and the study's equations for DLCO in males, highlighting the need for new reference values.

Conclusions:

  • The reference values derived from the study's prediction equations are more appropriate for the Japanese sample than those from existing equations.
  • The study successfully developed a more precise prediction equation for pulmonary diffusing capacity.
  • This contributes a valuable tool for establishing accurate reference value ranges in clinical practice.