Division of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
J Korean Med Sci. 2024 Jan 29;39(4):e20. doi: 10.3346/jkms.2024.39.e20.
Global Lung Function Initiative (GLI)-2012 reference equation is currently suggested for interpretation of spirometry results and a new local reference equation has been developed in South Korea. However, lung function profiles according to the different reference equations and their clinical relevance have not been identified in chronic obstructive pulmonary disease (COPD) patients.
Our cross-sectional study evaluated Choi's, Korean National Health and National Examination Survey (KNHANES)-VI, and GLI-2012 reference equations. We estimated the percentages of predictive forced expiratory volume in one second (FEV) and airflow limitation severity according to reference equations and analyzed their associations with patient reported outcomes (PROs): COPD assessment test (CAT) score, St. George's Respiratory Questionnaire for COPD patients (SGRQ-C) score, and six minute walk distance (6MWD).
In the eligible 2,180 COPD patients, lower predicted values of FEV and forced vital capacity (FVC) were found in GLI-2012 compared to Choi's and KNHANES-VI equations. GLI-2012 equation resulted in a lower proportion of patients being classified as FEV < 80% or FVC < 80% compared to the other equations. However, the Z-scores of FEV and FVC were similar between the KNHANES-VI and GLI-2012 equations. Three reference equations exhibited significant associations between FEV (%) and patient-reported outcomes (CAT score, SGRQ-C score, and 6MWD).
GLI-2012 reference equation may not accurately reflect FEV (%) in the Korean population, but the Z-score using GLI-2012 equation can be a viable option for assessing FEV and airflow limitation in COPD patients. Similar to the other two equations, the GLI-2012 equation demonstrated significant associations with PROs.
全球肺功能倡议（GLI）-2012 参考方程目前被建议用于解释肺活量测定结果，并且已经在韩国开发了新的本地参考方程。然而，根据不同的参考方程，以及它们在慢性阻塞性肺疾病（COPD）患者中的临床相关性，尚未确定肺功能特征。
我们的横断面研究评估了 Choi 氏、韩国国家健康和国家体检调查（KNHANES）-VI 和 GLI-2012 参考方程。我们根据参考方程估计了预测的一秒用力呼气量（FEV）和气流受限严重程度的百分比，并分析了它们与患者报告的结局（PRO）的关联：COPD 评估测试（CAT）评分、COPD 患者圣乔治呼吸问卷（SGRQ-C）评分和 6 分钟步行距离（6MWD）。
在符合条件的 2180 名 COPD 患者中，与 Choi 氏和 KNHANES-VI 方程相比，GLI-2012 方程预测的 FEV 和用力肺活量（FVC）值较低。与其他方程相比，GLI-2012 方程导致较少的患者被归类为 FEV <80%或 FVC <80%。然而，FEV 和 FVC 的 Z 评分在 KNHANES-VI 和 GLI-2012 方程之间相似。三个参考方程均显示 FEV（%）与患者报告的结局（CAT 评分、SGRQ-C 评分和 6MWD）之间存在显著关联。
GLI-2012 参考方程可能无法准确反映韩国人群的 FEV（%），但使用 GLI-2012 方程的 Z 评分可以成为评估 COPD 患者 FEV 和气流受限的可行选择。与其他两个方程一样，GLI-2012 方程与 PRO 具有显著相关性。
