Division of Pulmonary and Critical Care Medicine, Department of Medicine, and.
Information Technology, Mayo Clinic, Rochester, Minnesota; and.
Am J Respir Crit Care Med. 2024 Jan 1;209(1):83-90. doi: 10.1164/rccm.202303-0613OC.
Global Lung Function Initiative (GLI) Global spirometry reference equations were recently derived to offer a "race-neutral" interpretation option. The impact of transitioning from the race-specific GLI-2012 to the GLI Global reference equations is unknown. Describe the direction and magnitude of changes in predicted lung function measurements in a population of diverse race and ethnicity using GLI Global in place of GLI-2012 reference equations. In this multicenter cross-sectional study using a large pulmonary function laboratory database, 109,447 spirometry tests were reanalyzed using GLI Global reference equations and compared with the existing GLI-2012 standard, stratified by self-reported race and ethnicity. Mean FEV and FVC percent predicted increased in the White and Northeast Asian groups and decreased in the Black, Southeast Asian, and mixed/other race groups. The prevalence of obstruction increased by 9.7% in the White group, and prevalences of possible restriction increased by 51.1% and 37.1% in the Black and Southeast Asian groups, respectively. Using GLI Global in a population with equal representation of all five race and ethnicity groups altered the interpretation category for 10.2% of spirometry tests. Subjects who self-identified as Black were the only group with a relative increase in the frequency of abnormal spirometry test results (32.9%). The use of GLI Global reference equations will significantly impact spirometry interpretation. Although GLI Global offers an innovative approach to transition from race-specific reference equations, it is important to recognize the continued need to place these data within an appropriate clinical context.
全球肺功能倡议（GLI）最近推导出了全球肺功能参考方程，以提供“无种族偏见”的解释选项。从特定种族的 GLI-2012 过渡到 GLI 全球参考方程的影响尚不清楚。本研究旨在描述使用 GLI 全球替代 GLI-2012 参考方程时，不同种族和族裔人群的预测肺功能测量值变化的方向和幅度。在这项使用大型肺功能实验室数据库的多中心横断面研究中，重新分析了 109,447 次肺功能检查，使用 GLI 全球参考方程，并按自我报告的种族和族裔分层，与现有的 GLI-2012 标准进行比较。白人和东北亚人群的 FEV 和 FVC 预计百分比增加，而黑种人、东南亚人和混合/其他种族人群的 FEV 和 FVC 预计百分比降低。白种人群中阻塞的患病率增加了 9.7%，黑种人和东南亚人群中可能受限的患病率分别增加了 51.1%和 37.1%。在代表所有五个种族和族裔群体的人群中使用 GLI 全球会改变 10.2%的肺功能检查的解释类别。自我认定为黑人的受试者是唯一一组异常肺功能检查结果频率相对增加的人群（32.9%）。GLI 全球参考方程的使用将对肺功能检查的解释产生重大影响。尽管 GLI 全球提供了一种从特定种族参考方程过渡的创新方法，但重要的是要认识到仍然需要将这些数据置于适当的临床背景下。
