Department of Respiratory and Pulmonary Diseases, Vienna Healthcare Group, Clinic Penzing, Sanatoriumstrasse 2, Vienna, 1140, Austria.
Ludwig Boltzmann Institute for Lung Health, Vienna, Austria.
Respir Res. 2024 Apr 3;25(1):155. doi: 10.1186/s12931-024-02782-6.
Reference values for lung volumes are necessary to identify and diagnose restrictive lung diseases and hyperinflation, but the values have to be validated in the relevant population. Our aim was to investigate the Global Lung Function Initiative (GLI) reference equations in a representative healthy Austrian population and create population-derived reference equations if poor fit was observed.
We analysed spirometry and body plethysmography data from 5371 respiratory healthy subjects (6-80 years) from the Austrian LEAD Study. Fit with the GLI equations was examined using z-scores and distributions within the limits of normality. LEAD reference equations were then created using the LMS method and the generalized additive model of location shape and scale package according to GLI models.
Good fit, defined as mean z-scores between + 0.5 and -0.5,was not observed for the GLI static lung volume equations, with mean z-scores > 0.5 for residual volume (RV), RV/TLC (total lung capacity) and TLC in both sexes, and for expiratory reserve volume (ERV) and inspiratory capacity in females. Distribution within the limits of normality were shifted to the upper limit except for ERV. Population-derived reference equations from the LEAD cohort showed superior fit for lung volumes and provided reproducible results.
GLI lung volume reference equations demonstrated a poor fit for our cohort, especially in females. Therefore a new set of Austrian reference equations for static lung volumes was developed, that can be applied to both children and adults (6-80 years of age).
肺容积的参考值对于识别和诊断限制性肺疾病和过度充气是必要的，但这些值必须在相关人群中得到验证。我们的目的是研究全球肺功能倡议（GLI）参考方程在代表性的奥地利健康人群中的适用性，并在观察到拟合不良时创建基于人群的参考方程。
我们分析了来自奥地利 LEAD 研究的 5371 名呼吸健康受试者（6-80 岁）的肺活量测定和体描法数据。使用 z 分数和分布在正态范围的限制内检查 GLI 方程的拟合情况。然后，根据 GLI 模型，使用 LMS 方法和广义加性模型的位置形状和比例包创建 LEAD 参考方程。
对于 GLI 静态肺容积方程，未观察到良好的拟合，定义为平均 z 分数在+0.5 和-0.5 之间，在男女两性中，残气容积（RV）、RV/TLC（总肺容量）和 TLC 的平均 z 分数>0.5，以及女性的呼气储备容积（ERV）和吸气量。除了 ERV 之外，正态范围的分布都向上限转移。来自 LEAD 队列的基于人群的参考方程在肺容积方面表现出更好的拟合，提供了可重复的结果。
GLI 肺容积参考方程在我们的队列中表现出较差的拟合，尤其是在女性中。因此，为静态肺容积开发了一套新的奥地利参考方程，可应用于儿童和成人（6-80 岁）。
