Spirometric Reference Equations For Cameroonians Aged 4 To 89 Years Derived Using Lambda, Mu, Sigma (LMS) Method

Abstract

Background: Spirometric reference values ​​are well known in several ethnic groups but the normative spirometric values ​​of blacks living in Africa have been less studied. The purpose of this study is to establish normative spirometric equations from a representative population of Cameroonian children and adults and compare these equations with those developed by Global Lung Initiative (GLI) and in Nigerians.Methods: Spirometric data from healthy Cameroonians aged 4 to 89 years randomly collected between 2014 and 2018 were used to derive reference equations using generalized additive model for location (mu), shape (lambda) and scale (sigma).Results: A total of 625 children and adolescents (290 males and 335 females) and 1152 adults (552 males and 600 females) were included in the study. The prediction equation for any spirometric index was written as: M = Exp[a0 + a1*ln (Height) + a2*ln (Age) + Mspline, Mspline was age related spline contribution]. Applying the GLI standards for African Americans results in overall values ​​greater than those found in our study for forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). These values ​​were very close in children and adolescents while the values ​​obtained with the GLI equations for African Americans were significantly higher in adults. FEV1/FVC ratio in our study was similar for adult males but lower in adult females (88% vs 85%, difference = + 3.5%) when applying Nigerian standards. Conclusions: FEV1 and FVC of the Cameroonian population are very close to those of black American children and adolescents. However, FEV1 and FVC of Cameroonian adults are significantly lower than those of black American adults. These equations should allow a more suitable interpretation of spirometry in the Cameroonian population.

Abnormal spirometric patterns and respiratory symptoms in HIV patients with no recent pulmonary infection in a periurban hospital in Ghana

“…In addition, we used the GLI reference equation based on African American population for computing prediction values and LLN for spirometric values. The GLI equation is reported to significantly underestimate FEV1 and FVC by 9% in the Cameroonian population [32], implying that the performance of GLI equations in the SSA adult population may be limited. Therefore, there is a need for deriving locally reference values from the Ghanaian population for accurate interpretation of spirometric values.…”