Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, NT, Australia.
College of Health and Human Sciences, Charles Darwin University, Darwin, NT, Australia.
Int J Chron Obstruct Pulmon Dis. 2022 Apr 21;17:869-881. doi: 10.2147/COPD.S361839. eCollection 2022.
Comparison of spirometry parameters between Indigenous and non-Indigenous patients with underlying chronic obstructive pulmonary disease (COPD) has been sparsely reported in the past. In this study, differences in the lung function parameters (LFPs), in particular spirometry values for forced vital capacity (FVC), forced expiratory volume in one second (FEV) and FEV/FVC ratio between Indigenous and non-Indigenous patients with COPD were assessed.
In this retrospective study, Indigenous and non-Indigenous patients with a diagnosis of COPD between 2012-2020 according to spirometry criteria (ie; post-bronchodilator (BD) FEV/FVC < 0.7) were included. A further analysis was undertaken to compare the differences in the spirometry parameters, including lower limit of normal (LLN) values matching for age, sex, height and smoking status between these two diverse ethnic populations.
A total of 240/742 (32%) Indigenous and 873/4579 (19%) non-Indigenous patients were identified to fit the criteria for COPD. Indigenous patients were significantly younger (mean difference 9.9 years), with a greater proportion of females (50% vs 33%), underweight (20% vs 8%) and current smokers (47% vs 32%). Prior to matching, Indigenous patients' post-BD percent predicted values for FVC, FEV, and FEV/FVC ratio were 17, 17%, and -2 points lower (Hedges G measure of effect size large (0.91), large (0.87), and small (0.25), respectively). Among the matched cohort (111 Indigenous and non-Indigenous), Indigenous patients LFPs remained significantly lower, with a mean difference of 16%, 16%, and -4, respectively (Hedges G large (0.94), large (0.92) and small (0.41), respectively). The differences persisted despite no significant differences in LLN values for these parameters.
Indigenous Australian patients with COPD display a significantly different demographic and clinical profile than non-Indigenous patients. LFPs were significantly lower, which may or may not equate to greater severity of disease in the absence of normative predictive lung function reference values specific to this population.
过去对基础慢性阻塞性肺疾病（COPD）的土著和非土著患者的肺功能参数（LFPs）进行比较的研究很少。在这项研究中，评估了 COPD 土著和非土著患者的肺功能参数（特别是用力肺活量（FVC）、一秒用力呼气量（FEV）和 FEV/FVC 比值的肺活量测定值）的差异。
在这项回顾性研究中，根据肺活量测定标准（即支气管扩张剂后（BD）FEV/FVC<0.7），纳入了 2012 年至 2020 年诊断为 COPD 的土著和非土著患者。还进行了进一步的分析，以比较这两个不同种族人群之间的肺活量测定参数差异，包括年龄、性别、身高和吸烟状况匹配的正常下限（LLN）值。
总共确定了 240/742（32%）名土著和 873/4579（19%）名非土著患者符合 COPD 的标准。土著患者明显更年轻（平均差异为 9.9 岁），女性比例更高（50%比 33%），体重不足（20%比 8%）和当前吸烟者（47%比 32%）更多。在匹配之前，BD 后土著患者的 FVC、FEV 和 FEV/FVC 比值的百分比预测值分别低 17、17%和-2 点（Hedges G 效应量大小（0.91）、大（0.87）和小（0.25））。在匹配队列（111 名土著和非土著）中，土著患者的 LFPs 仍然明显较低，分别为 16%、16%和-4，差异具有统计学意义（Hedges G 大小分别为大（0.94）、大（0.92）和小（0.41））。尽管这些参数的 LLN 值没有显著差异，但差异仍然存在。
与非土著患者相比，澳大利亚土著患者的 COPD 表现出明显不同的人口统计学和临床特征。LFPs 明显较低，这可能意味着在缺乏针对该人群的特定预测肺功能正常值的情况下，疾病的严重程度更大。
