Are Race and Sex Differences in Lung Function Explained by Frame Size?: The CARDIA Study

Jacobs, David R.; Nelson, Eileen T.; Dontas, A. S.; Keller, Jacob B.; Slattery, Martha L.; Higgins, Millicent

doi:10.1164/ajrccm/146.3.644

Cited by 42 publications

(23 citation statements)

References 4 publications

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“…Blacks and women also had lower FEV 1 at age 18, a difference that was accentuated by age 40. This study corroborates the findings of other published reports that have described lower lung function in blacks than in whites and in women than in men of the same race (17,(27)(28)(29)(30)(31)(32)(33)(34). Harik-Khan and coworkers found this difference to be partially explained by a shorter upper body segment in blacks (35).…”

Section: Peak Plateau Decline Race and Sexsupporting

confidence: 92%

“…Daily checks for leaks and volume calibration with a 3-L syringe and weekly calibration in the 4-to 7-L range were undertaken to minimize methodological artifacts between exams. We analyzed FEV 1 (maximum of five satisfactory maneuvers) adjusted for height squared (FEV 1 /ht 2 ) (14)(15)(16)(17). To ease interpretation, we multiplied by the mean ht 2 and presented FEV 1 .…”

Section: Participants and Measurementsmentioning

confidence: 99%

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Early Life Factors Contribute to the Decrease in Lung Function between Ages 18 and 40

Apostol

Jacobs

Tsai

et al. 2002

Am J Respir Crit Care Med

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142

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Early life factors may influence pulmonary function. We measured forced expiratory volume in 1 second (FEV(1)) in 1985-1986 and 2, 5, and 10 years later in approximately 4,000 black and white men and women initially aged 18-30 years. We estimated the age pattern of FEV(1) according to family smoking status, early diagnosis of asthma, early smoking initiation, adult asthma, and cigarette smoking. FEV(1) followed a quadratic pattern from age of peak through age 40. The pattern varied by race and sex. Early smoking initiation was associated with a faster decrease in FEV(1). Smoking by family members was related to early life asthma and may have contributed to faster FEV(1) decrease by encouraging behaviors such as heavier smoking or earlier smoking initiation. Prevalence of smoking was 28% when no family member smoked, compared with 59% when four or more members smoked. The FEV(1) decline was 8.5% in never-smokers without asthma; 10.1% in nonsmoking individuals diagnosed with asthma; and 11.1% in baseline smokers who smoked 15 or more cigarettes per day. The combination of asthma and heavier smoking was synergistic (17.8% decline). This study delineates an increased rate of decline in those with asthma or in those who smoke cigarettes and implicates early life exposures as contributing to the faster rate of FEV(1) decline.

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Section: Peak Plateau Decline Race and Sexsupporting

confidence: 92%

Section: Participants and Measurementsmentioning

confidence: 99%

Early Life Factors Contribute to the Decrease in Lung Function between Ages 18 and 40

Apostol

Jacobs

Tsai

et al. 2002

Am J Respir Crit Care Med

Self Cite

142

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“…1,2 Most studies focused on differences in spirometry, showing that white subjects have, at all ages, larger values of height-normalized forced vital capacity (FVC) and forced expired volume in 1 second (FEV 1 ) than either black or Asian populations; reported differences vary from 8% to 17%. [3][4][5][6][7][8][9][10][11][12][13] Measurements of flow (which may reflect airway caliber rather than volume) have been studied less frequently and have not always been normalized for height. Some reports indicate significant differences in flows among people of various ethnic groups, 3,6,14 whereas others show little or no difference.…”

Section: Discussionmentioning

confidence: 99%

Etiology of Ethnic Differences in Childhood Spirometry

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT:There are ethnic differences in lung function, with white people generally having higher values of FVC and FEV 1 than people of South Asian origin, whereas differences in forced expiratory flows are absent or less marked. The underlying reasons are unknown.WHAT THIS STUDY ADDS: Lung function differences were not explained by cultural, socioeconomic, or perinatal factors, nor by environmental exposures or wheezing illness. This suggests that genetic factors are responsible, and supports the use of ethnicityspecific prediction equations for children of South Asian origin. abstract OBJECTIVES: Age-and height-adjusted spirometric lung function of South Asian children is lower than those of white children. It is unclear whether this is purely genetic, or partly explained by the environment. In this study, we assessed whether cultural factors, socioeconomic status, intrauterine growth, environmental exposures, or a family and personal history of wheeze contribute to explaining the ethnic differences in spirometric lung function. METHODS:We studied children aged 9 to 14 years from a populationbased cohort, including 1088 white children and 275 UK-born South Asians. Log-transformed spirometric data were analyzed using multiple linear regressions, adjusting for anthropometric factors. Five different additional models adjusted for (1) cultural factors, (2) indicators of socioeconomic status, (3) perinatal data reflecting intrauterine growth, (4) environmental exposures, and (5) personal and family history of wheeze.RESULTS: Height-and gender-adjusted forced vital capacity (FVC) and forced expired volume in 1 second (FEV 1 ) were lower in South Asian than white children (relative difference -11% and -9% respectively, P , .001), but PEF and FEF 50 were similar (P $ .5). FEV 1 /FVC was higher in South Asians (1.8%, P , .001). These differences remained largely unchanged in all 5 alternative models. CONCLUSIONS:Our study confirmed important differences in lung volumes between South Asian and white children. These were not attenuated after adjustment for cultural and socioeconomic factors and intrauterine growth, neither were they explained by differences in environmental exposures nor a personal or family history of wheeze. This suggests that differences in lung function may be mainly genetic in origin. The implication is that ethnicity-specific predicted values remain important specifically for South Asian children. Pediatrics 2013;131:e1842-e1849

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“…Anthropometric differences, nutritional status, socioeconomic and environment factors may explain the racial differences in pulmonary lung functions [4,5,12]. According to Jacobs et al [24], differences in FEV 1 and FVC among races exist even after detailed adjustment for frame size based on sitting height, leg height, elbow breadth and biacromial diameter.…”

Section: Discussionmentioning

confidence: 99%

Spirometric Reference Values for an East-African Population

Musafiri

Meerbeeck

Musango³

et al. 2012

Respiration

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Background: Accurate interpretation of lung function testing requires appropriate reference values. Unfortunately, few African countries have produced spirometric reference values for their populations. Objectives: The present study was carried out in order to establish normal lung function values for subjects living in Rwanda, East Africa. Methods: The study was conducted in Kigali, capital of Rwanda, and in the rural district of Huye in southern Rwanda. The variables studied were forced expiratory volume in 1 s (FEV₁), forced vital capacity (FVC) and peak expiratory flow. Multiple regression analysis was performed using age, height, weight and BMI as independent variables to obtain predicted equations for both sexes. Results: Predicted equations for normal lung functions were obtained from 740 healthy nonsmoking subjects; 394 were females and 346 were males. Minor differences in FEV₁ and FVC were observed in comparison with other studies of Africans, African-Americans (difference in FEV₁ and FVC of less than 5%), Chinese and Indians. When compared with selected studies from Caucasians and white Americans, our results for FEV₁ and FVC were 9-12% and 16-18% lower in men and 12-23% and 17-28% lower in women, respectively. Conclusions: This study provides reference values for pulmonary function in a healthy, nonsmoking Rwandan population and enables comparisons to be made with other prediction equations from other populations. Spirometric reference values in our study were similar to those obtained in a study of black Americans by Hankinson et al. [Am J Crit Care Med 1999;159:179-187].

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Are Race and Sex Differences in Lung Function Explained by Frame Size?: The CARDIA Study

Cited by 42 publications

References 4 publications

Early Life Factors Contribute to the Decrease in Lung Function between Ages 18 and 40

Early Life Factors Contribute to the Decrease in Lung Function between Ages 18 and 40

Etiology of Ethnic Differences in Childhood Spirometry

Spirometric Reference Values for an East-African Population

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