韩国三个独立出生队列中健康儿童的肺功能：全球肺功能倡议 2012 方程的验证。

Pulmonary function of healthy Korean children from three independent birth cohorts: Validation of the Global Lung Function Initiative 2012 equation.

机构信息

Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.

Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea.

出版信息

Pediatr Pulmonol. 2021 Oct;56(10):3310-3320. doi: 10.1002/ppul.25622. Epub 2021 Aug 25.

DOI:10.1002/ppul.25622

PMID:34375041

Abstract

BACKGROUND AND OBJECTIVE

Global Lung Function Initiative (GLI) 2012 equations were developed to resolve the age-related disparity in interpreting spirometry results. Local validation of the equation is needed, especially in Northeast Asian children. This study evaluated the GLI equation in Korean children.

METHODS

Spirometry indices (FEV1, FVC, FEV1/FVC, and FEF25%-75%) and clinical information were gathered from three population-based birth cohorts. Predicted GLI reference values and z scores of spirometry results were calculated for 1239 healthy children. The mean, standard deviation of z scores were compared with the expected 0 and 1. Probabilities of falling below the lower limit of normal (LLN) (z score: -1.64) were compared with the expected value 5%. GLI z scores were assessed according to low (<-2), normal (≥-2 and ≤2), and high (>2) BMI z score groups.

RESULTS

Mean z scores significantly differed from 0 for FEV1/FVC in males (mean [95% confidence interval]: 0.18 [0.08, 0.27]) and forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) in females (-0.23 [-0.31, -0.15] and -0.26 [-0.36, -0.16], respectively). The standard deviation was larger than 1 for all variables in males and FVC and FEV1/FVC in females. The probability of falling below the LLN was significantly larger than 5% for FEV1 (12.13% [9.64, 14.77]), FVC (15.86% [13.06, 18.81]), and forced expiratory flow at 25%-75% of forced vital capacity (FEF25%-75%) (7.31% [5.29, 9.49]) in males and FVC (11.91% [9.40, 14.60]) in females. FEV1 and FVC z scores increased across low to high body mass index (BMI) groups, and FEV1/FVC decreased from low to high BMI groups.

CONCLUSION

GLI equations marginally differ from real-world values, which should be considered by pulmonologists in practice or research.

摘要

背景与目的

全球肺功能倡议（GLI）2012 方程旨在解决解释肺活量测试结果时与年龄相关的差异。需要对该方程进行本地验证，特别是在东北亚儿童中。本研究评估了 GLI 方程在韩国儿童中的适用性。

方法

从三个基于人群的出生队列中收集了肺活量测试指数（FEV1、FVC、FEV1/FVC 和 FEF25%-75%）和临床信息。为 1239 名健康儿童计算了 GLI 参考值预测值和肺活量测试结果的 z 分数。比较了 z 分数的平均值和标准差与预期的 0 和 1。比较了低于正常下限（LLN）（z 分数：-1.64）的概率与预期的 5%。根据低（< -2）、正常（≥-2 且≤2）和高（>2）体重指数（BMI）z 分数组评估了 GLI z 分数。

结果

男性的 FEV1/FVC（平均值[95%置信区间]：0.18[0.08，0.27]）和 1 秒用力呼气量（FEV1）和用力肺活量（FVC）的 z 分数显著偏离 0，而女性的 FEV1 和 FVC 的 z 分数分别为-0.23[-0.31，-0.15]和-0.26[-0.36，-0.16]。所有变量的标准差在男性中均大于 1，而在女性中 FVC 和 FEV1/FVC 的标准差大于 1。男性的 FEV1（12.13%[9.64%，14.77%]）、FVC（15.86%[13.06%，18.81%]）和用力呼气流量在 25%-75%用力肺活量时的 25%-75%（FEF25%-75%）（7.31%[5.29%，9.49%]）以及女性的 FVC（11.91%[9.40%，14.60%]）低于 LLN 的概率显著大于 5%。男性的 FEV1 和 FVC z 分数随着低体重指数（BMI）到高 BMI 组的增加而增加，而 FEV1/FVC 则从低 BMI 组到高 BMI 组降低。