Quanjer Philip H, Kubota Masaru, Kobayashi Hirosuke, Omori Hisamitsu, Tatsumi Koichiro, Kanazawa Minoru, Stanojevic Sanja, Stocks Janet, Cole Tim J
Department of Pulmonary Diseases, Department of Paediatrics, Division of Respiratory Medicine, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands.
Department of Respiratory Medicine, School of Medicine, Kitasato University, Kanagawa, Japan.
Chest. 2015 Mar;147(3):792-797. doi: 10.1378/chest.14-1365.
Most but not all data from different ethnic groups fit the Global Lung Function Initiative (GLI) spirometric reference model. This study investigates to what extent discrepancies are caused by secular changes in body proportions.
FEV1 and FVC from 20,336 healthy Japanese subjects (13,492 women) aged 17 to 95 years were compared with GLI-2012 reference values for Europeans. Data on the sitting height/standing height ratio (Cormic index) in 17-year-old students, collected from 1949 to 2012 in successive birth cohorts, were used to assess secular changes in body frame. The cohort-specific Cormic index was used to assess how variation in body frame affected pulmonary function.
FEV1 and FVC were lower than GLI-2012 reference values, with values progressively falling until age 35 to 40 years and then rising to European levels in the elderly. The Cormic index rose until 1942, then fell, with a nadir in the 1970s, before rising again until 1995. Nearly one-half of the spirometric variability from predicted values could be explained by differences in the Cormic index between birth cohorts.
In low-income countries, improving health conditions are likely to drive increases in height and changes in relative leg length similar to those observed in Japan and, thus, to a change in body frame. This implies that height-based prediction equations for such populations will need to be periodically updated.
来自不同种族群体的大部分（但并非全部）数据符合全球肺功能倡议（GLI）肺量计参考模型。本研究调查了身体比例的长期变化在多大程度上导致了差异。
将20336名年龄在17至95岁之间的健康日本受试者（13492名女性）的第一秒用力呼气容积（FEV1）和用力肺活量（FVC）与欧洲人的GLI - 2012参考值进行比较。1949年至2012年连续出生队列中收集的17岁学生的坐高/身高比（科米克指数）数据用于评估身体框架的长期变化。特定队列的科米克指数用于评估身体框架变化如何影响肺功能。
FEV1和FVC低于GLI - 2012参考值，其值在35至40岁之前逐渐下降，然后在老年人中升至欧洲水平。科米克指数在1942年之前上升，然后下降，在20世纪70年代达到最低点，之后再次上升直至1995年。出生队列之间科米克指数的差异可以解释近一半的肺量计预测值变异性。
在低收入国家，健康状况的改善可能会推动身高增加以及相对腿长变化，类似于在日本观察到的情况，从而导致身体框架改变。这意味着针对此类人群基于身高的预测方程需要定期更新。
