Diffusing Capacity of the Lung for Carbon Monoxide in Mexican/Latino Children. Quality Control and Reference Values

Gochicoa‐Rangel, Laura; Del-Río-Hidalgo, Rodrigo; Álvarez-Arroyo, María René; Martínez-Briseño, David; Mora-Romero, Uri; Martínez-Valdeavellano, Luisa; Navarrete-Rivera, Johanna; Rodríguez‐Moreno, Luis; Guerrero-Zúñiga, Selene; Fernández-Plata, Rosario; Cantú-González, Gabriela; Cid-Juárez, Silvia; García-Sancho, Cecilia; Thirión-Romero, Ireri; Silva-Cerón, Mónica; Pérez‐Padilla, Rogelio; Torre-Bouscoulet, Luis

doi:10.1513/annalsats.201712-922oc

Cited by 5 publications

(2 citation statements)

References 25 publications

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“…Because noticeable differences between male and female children are usually observe for PFTs variables, and because our preliminary analyses showed that associations of cytokines/hormones with lung function differed between boys and girls, all analyses were performed separately for each sex. Each PFTs variable was evaluated as raw values or as values converted to their respective z‐scores (z) according to reference populations (Gochicoa‐Rangel et al., 2015 , 2019 ; Martínez‐Briseño et al., 2020 ). Normal distribution of all variables was corroborated through the Kolmogorov–Smirnov test (the original concentration of salivary biomarkers was first log‐transformed to achieve a normal distribution).…”

Section: Methodsmentioning

confidence: 99%

Lung function is related to salivary cytokines and hormones in healthy children. An exploratory cross‐sectional study

Gochicoa‐Rangel,

Chávez,

Del‐Río‐Hidalgo

et al. 2023

Physiological Reports

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Pulmonary mechanics has been traditionally viewed as determined by lung size and physical factors such as frictional forces and tissue viscoelastic properties, but few information exists regarding potential influences of cytokines and hormones on lung function. Concentrations of 28 cytokines and hormones were measured in saliva from clinically healthy scholar children, purposely selected to include a wide range of body mass index (BMI). Lung function was assessed by impulse oscillometry, spirometry, and diffusing capacity for carbon monoxide, and expressed as z‐score or percent predicted. Ninety‐six scholar children (55.2% female) were enrolled. Bivariate analysis showed that almost all lung function variables correlated with one or more cytokine or hormone, mainly in boys, but only some of them remained statistically significant in the multiple regression analyses. Thus, after adjusting by height, age, and BMI, salivary concentrations of granulocyte‐macrophage colony‐stimulating factor (GM‐CSF) in boys were associated with zR5‐R20 and reactance parameters (zX20, zFres, and zAX), while glucagon inversely correlated with resistances (zR5 and zR20). Thus, in physiological conditions, part of the mechanics of breathing might be influenced by some cytokines and hormones, including glucagon and GM‐CSF. This endogenous influence is a novel concept that warrants in‐depth characterization.

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Section: Methodsmentioning

confidence: 99%

Lung function is related to salivary cytokines and hormones in healthy children. An exploratory cross‐sectional study

Gochicoa‐Rangel,

Chávez,

Del‐Río‐Hidalgo

et al. 2023

Physiological Reports

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“…Prediction equations for DLCO were developed to decipher normal from abnormal gas transfer through the lung. These equations have been created for adults [ 2 – 8 ] and children [ 9 – 11 ], with a wide range of racial backgrounds [ 11 – 20 ].…”

Section: Introductionmentioning

confidence: 99%

The need for race-specific reference equations for pulmonary diffusing capacity for nitric oxide

et al. 2021

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Background Few reference equations exist for healthy adults of various races for pulmonary diffusing capacity for nitric oxide (DLNO). The purpose of this study was to collect pilot data to demonstrate that race-specific reference equations are needed for DLNO. Methods African Americans (blacks) were chosen as the comparative racial group. In 2016, a total of 59 healthy black subjects (27 males and 32 females) were recruited to perform a full battery of pulmonary function tests. In the development of DLNO reference equations, a white reference sample (randomly drawn from a population) matched to the black sample for sex, age, and height was used. Multiple linear regression equations for DLNO, alveolar volume (VA), and pulmonary diffusing capacity for carbon monoxide (DLCO) using a 5–6 s breath-hold were developed. Results Our models demonstrated that sex, age2, race, and height explained 71% of the variance in DLNO and DLCO, with race accounting for approximately 5–10% of the total variance. After normalizing for sex, age2, and height, blacks had a 12.4 and 3.9 mL/min/mmHg lower DLNO and DLCO, respectively, compared to whites. The lower diffusing capacity values in blacks are due, in part, to their 0.6 L lower VA (controlling for sex and height). Conclusion The results of this pilot data reveal small but important and statistically significant racial differences in DLNO and DLCO in adults. Future reference equations should account for racial differences. If these differences are not accounted for, then the risk of falsely diagnosing lung disease increase in blacks when using reference equations for whites.

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Reference equations for DLNO and DLCO in Mexican Hispanics: influence of altitude and race

Gochicoa-Rangel,

De-Los-Santos-Martínez,

Reyes-García

et al. 2024

BMJ Open Resp Res

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ObjectivesThis study aimed to evaluate pulmonary diffusing capacity for nitric oxide (DLNO) and pulmonary diffusing capacity for carbon monoxide (DLCO) in Mexican Hispanics born and raised at 2240 m altitude (midlanders) compared with those born and raised at sea level (lowlanders). It also aimed to assess the effectiveness of race-specific reference equations for pulmonary diffusing capacity (white people vs Mexican Hispanics) in minimising root mean square errors (RMSE) compared with race-neutral equations.MethodsDLNO, DLCO, alveolar volume (VA) and gas transfer coefficients (KNO and KCO) were measured in 392 Mexican Hispanics (5 to 78 years) and compared with 1056 white subjects (5 to 95 years). Reference equations were developed using segmented linear regression (DLNO, DLCO and VA) and multiple linear regression (KNO and KCO) and validated with Least Absolute Shrinkage and Selection Operator. RMSE comparisons between race-specific and race-neutral models were conducted using repeated k-fold cross-validation and random forests.ResultsMidlanders exhibited higher DLCO (mean difference: +4 mL/min/mm Hg), DLNO (mean difference: +7 mL/min/mm Hg) and VA (mean difference: +0.17 L) compared with lowlanders. The Bayesian information criterion favoured race-specific models and excluding race as a covariate increased RMSE by 61% (DLNO), 18% (DLCO) and 4% (KNO). RMSE values for VA and KCO were comparable between race-specific and race-neutral models. For DLCO and DLNO, race-neutral equations resulted in 3% to 6% false positive rates (FPRs) in Mexican Hispanics and 20% to 49% false negative rates (FNRs) in white subjects compared with race-specific equations.ConclusionsMexican Hispanics born and raised at 2240 m exhibit higher DLCO and DLNO compared with lowlanders. Including race as a covariate in reference equations lowers the RMSE for DLNO, DLCO and KNO and reduces FPR and FNR compared with race-neutral models. This study highlights the need for altitude-specific and race-specific reference equations to improve pulmonary function assessments across diverse populations.

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Diffusing Capacity of the Lung for Carbon Monoxide in Mexican/Latino Children. Quality Control and Reference Values

Cited by 5 publications

References 25 publications

Lung function is related to salivary cytokines and hormones in healthy children. An exploratory cross‐sectional study

Lung function is related to salivary cytokines and hormones in healthy children. An exploratory cross‐sectional study

The need for race-specific reference equations for pulmonary diffusing capacity for nitric oxide

Reference equations for DLNO and DLCO in Mexican Hispanics: influence of altitude and race

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