Reference values of spirometry for Finnish adults

Abstract

forced expiratory volume in one second; GLI2012; lung function; reference values; spirometry Background Diagnostic assessment of lung function necessitates up-to-date reference values. The aim of this study was to estimate reference values for spirometry for the Finnish population between 18 and 80 years and to compare them with the existing Finnish, European and the recently published global GLI2012 reference values. Methods Spirometry was performed for 1380 adults in the population-based FinEsS studies and for 662 healthy non-smoking volunteer adults. Detailed predefined questionnaire screening of diseases and symptoms, and quality control of spirometry yielded a sample of 1000 native Finns (387 men) healthy non-smokers aged 18-83 years. Sex-specific reference values, which are estimated using the GAMLSS method and adjusted for age and height, are provided. Results The predicted values for lung volumes are larger than those obtained by GLI2012 prediction for the Caucasian subgroup for forced vital capacity (FVC) by an average 6Á2% and 5Á1% and forced expiratory volume in 1 s (FEV1) by an average 4Á2% and 3Á0% in men and women, respectively. GLI2012 slightly overestimated the ratio FEV1/FVC with an age-dependent trend. Most reference equations from other European countries, with the exception of the Swiss SAPAL-DIA study, showed an underestimation of FVC and FEV1 to varying degrees, and a slight overestimation of FEV1/FVC. Conclusion This study offers up-to-date reference values of spirometry for native Finns with a wide age range. The GLI2012 predictions seem not to be suitable for clinical use for native Finns due to underestimation of lung volumes.

The multi‐ethnic global lung initiative 2012 (GLI-2012) norms reflect contemporary adult's Algerian spirometry

“…In order to avoid biased assessment of outcomes [40] and the sex-related effect on lung function [41] , similar percentages of men and women were included in this study. This was not the case of some others [15, 18, 19, 23] . For example, while the German study [18] included only women and the Tanzanian one only men [23] , in the Finnish [19] and the Tunisian [15] studies, women represented respectively, 61.3% and 19.6% of the total sample (Table 4) .…”

“…This was not the case of some others [15, 18, 19, 23] . For example, while the German study [18] included only women and the Tanzanian one only men [23] , in the Finnish [19] and the Tunisian [15] studies, women represented respectively, 61.3% and 19.6% of the total sample (Table 4) . In line with similar studies [14, 15, 19, 20] (Table 4) , the present one included adults with large age range (18 to 85 years, mean age: 48 years), a point that increases its external validity.…”

“…Moreover, data included in the 2016-Norway [20] , in the 2016-German [18] and in the 2015-French [17] studies were derived, respectively, from four studies published between 2007 and 2014, from five studies published between 2005 and 2015 and from a study published in 2015. However, it was better to include more than one center, as done in some studies (n = 3 populations bases studies [20] , n = 4 locations [19] ; n = 14 centers [16] ).…”

“…For example, while the German study [18] included only women and the Tanzanian one only men [23] , in the Finnish [19] and the Tunisian [15] studies, women represented respectively, 61.3% and 19.6% of the total sample (Table 4) . In line with similar studies [14, 15, 19, 20] (Table 4) , the present one included adults with large age range (18 to 85 years, mean age: 48 years), a point that increases its external validity. Other related studies included either elderly adults aged 52 years and more [18] or adults with a narrow age range [17] or a mixture of children and adults [23] .…”

“…On the one hand, some authors opted for their use to interpret spirometry, for example in the Australasian [16] , Norwegian [20] , German [18] and French [17] populations. On the other hand, the GLI-2012 norms seem unsuitable for clinical use in the Swedish [14] , Finnish [19] and Brazilian [22] populations. Moreover, a Chinese study [24] , concluded that GLI-2012 norms [10] showed unfavorable generalizability to their sample population.…”