Institute for Anthropological Research, Zagreb, Croatia.
Respir Med. 2009 Apr;103(4):621-8. doi: 10.1016/j.rmed.2008.10.013. Epub 2008 Nov 22.
This study identifies equations for predicting lung function values in a population of 'healthy', nonsmoking older adults, explores the applicability of prediction equations derived from younger adult populations to the elderly, and examines the justification of developing population-specific reference equations for older age. FVC, FEV(1), and PEF were measured according to the ATS criteria in 651 ambulatory volunteers aged 65-86 years, representative for the Croatian Mediterranean population. After exclusion of eversmokers and subjects with respiratory symptoms and/or diseases, 261 asymptomatic subjects were included in the analyses. Sex-specific reference equations and lower limits of normal were derived by using a linear model with height and age as predictors. The equations for lung volumes were more reliable than those for PEF. The new FVC and FEV(1) reference equations were found to be in agreement with those generated previously from primarily young and middle-aged adults. The latter perform reasonably well when extrapolated for ages beyond 65 years. Cross-validation of reference equations existing for the elderly showed that almost all European and U.S. equations systematically overpredicted lung function parameters in the Croatian sample. The overpredictions in means ranged between 14% and 34% for FVC and between 10% and 20% for FEV(1). Differences increased towards the extremes of distribution, which rendered these equations inappropriate for our elderly subjects. They identified FVC in 25-55% of the subjects as being below the lower limit of normal. The observed discrepancies strongly support the establishment of age- and population-specific reference equations for lung function assessment in older age.
本研究旨在为“健康”、不吸烟的老年人群体建立预测肺功能值的方程，探讨从年轻成年人人群中得出的预测方程在老年人中的适用性，并研究为老年人群体制定特定人群参考方程的合理性。本研究共纳入了 651 名年龄在 65-86 岁的、具有代表性的克罗地亚地中海地区的门诊志愿者，按照 ATS 标准测量了 FVC、FEV(1) 和 PEF。在排除了所有吸烟者以及有呼吸系统症状和/或疾病的个体后，共有 261 名无症状个体被纳入了分析。通过使用身高和年龄作为预测变量的线性模型，得出了性别特异性参考方程和正常下限。与 PEF 相比，肺容积方程更为可靠。新的 FVC 和 FEV(1) 参考方程与之前主要由年轻和中年成年人得出的方程一致。当将这些方程外推至 65 岁以上年龄时，它们的表现相当合理。对现有的适用于老年人的参考方程进行交叉验证的结果表明，几乎所有欧洲和美国的方程在克罗地亚样本中都系统地高估了肺功能参数。在平均值方面，FVC 的高估范围在 14%至 34%之间，FEV(1) 的高估范围在 10%至 20%之间。这些差异在分布的极端值处增大，这使得这些方程不适合我们的老年人群体。它们将 25-55%的个体的 FVC 识别为低于正常下限。观察到的差异强烈支持为老年人群体的肺功能评估制定特定年龄和特定人群的参考方程。
