Pistea Cristina, Lonsdorfer Evelyne, Doutreleau Stéphane, Oswald Monique, Enache Irina, Charloux Anne
Service de Physiologie et d'Explorations Fonctionnelles, Pôle de Pathologie Thoracique, Hôpitaux Universitaires de Strasbourg et Equipe d'Accueil 3072, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France.
ERJ Open Res. 2016 Mar 17;2(1). doi: 10.1183/23120541.00068-2015. eCollection 2016 Jan.
We evaluated the impact of selection of reference values on the categorisation of measured maximal oxygen consumption (') as "normal" or "abnormal" in an ageing population. We compared measured ' with predicted values and the lower limit of normal (LLN) calculated with five equations. 99 (58 males and 41 females) disease-free subjects aged ≥70 years completed an incremental maximal exercise test on a cycle ergometer. Mean ' was 1.88 L·min in men and 1.26 L·min in women. ' ranged from 89% to 108% of predicted in men, and from 88% to 164% of predicted in women, depending on the reference equation used. The proportion of subjects below the LLN ranged from 5% to 14% in men and 0-22% in women, depending on the reference equation. The LLN was lacking in one study, and was unsuitable for women in another. Most LLNs ranged between 53% and 73% of predicted. Therefore, choosing an 80% cut-off leads to overestimation of the proportion of "abnormal" subjects. To conclude, the proportion of subjects aged ≥70 years with a "low" ' differs markedly according to the chosen reference equations. In clinical practice, it is still relevant to test a sample of healthy volunteers and select the reference equations that better characterise this sample.
我们评估了在老年人群中,选择参考值对将测量的最大摄氧量( )分类为“正常”或“异常”的影响。我们将测量的 与预测值以及用五个公式计算出的正常下限(LLN)进行了比较。99名(58名男性和41名女性)年龄≥70岁的无病受试者在自行车测力计上完成了递增式最大运动测试。男性的平均 为1.88 L·min,女性为1.26 L·min。根据所使用的参考公式,男性的 为预测值的89%至108%,女性为预测值的88%至164%。根据参考公式,男性低于LLN的受试者比例为5%至14%,女性为0%至22%。一项研究中缺少LLN,另一项研究中的LLN不适用于女性。大多数LLN在预测值的53%至73%之间。因此,选择80%的截断值会高估“异常”受试者的比例。总之,根据所选的参考公式,年龄≥70岁且 “低”的受试者比例有显著差异。在临床实践中,对健康志愿者样本进行测试并选择能更好地表征该样本的参考公式仍然是有意义的。