Implications of reference equations for interpretation of spirometry in three African countries: a cross-sectional study
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View abstract on PubMed
Summary
This summary is machine-generated.The Global Lung Function Initiative (GLI) Global equation may overestimate lung function impairment in East/Southern Africa. African reference equations showed similar fit to GLI African American, suggesting the need for regionally specific spirometry data.
Area Of Science
- Pulmonary Medicine
- Respiratory Physiology
- Public Health
Background
- The Global Lung Function Initiative (GLI) Global spirometry reference equation lacks representation from Africa.
- GLI Global has not been validated in East/Southern Africa.
- This study evaluates GLI and African reference equations in this region.
Purpose Of The Study
- To assess the fit and diagnostic implications of GLI and African spirometry reference equations in East/Southern Africa.
- To compare lung function classifications using different reference equations.
Main Methods
- Utilized post-bronchodilator spirometry data from 806 healthy individuals (≥10 years) in Mozambique, Tanzania, and Zimbabwe.
- Calculated forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC z-scores.
- Compared proportions of obstructive airways disease and preserved-ratio impaired spirometry across different equations.
Main Results
- The GLI "African American" equation provided the best fit among GLI equations.
- GLI Global identified twice as many individuals with preserved-ratio impaired spirometry compared to the "African American" equation (22% vs. 11%).
- Proportions of obstruction were similar across "African American" and GLI Global equations (4.2% vs. 3.8%). African-developed equations showed comparable fit to GLI "African American".
Conclusions
- Reference equations significantly impact clinical and public health assessments, especially in resource-limited settings.
- GLI Global may lead to over-diagnosis of lung function impairment in this population.
- Further research incorporating clinical outcomes is necessary to ensure global representativeness of GLI Global.
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