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Reference values for spirometry – report from the Obstructive Lung Disease in Northern Sweden studies

机译：肺活量测定的参考值–瑞典北部阻塞性肺疾病研究报告

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BackgroundAbnormal lung function is commonly identified by comparing observed spirometric values to corresponding reference values. It is recommended that such reference values for spirometry are evaluated and updated frequently. The aim of this study was to estimate new reference values for Swedish adults by fitting a multivariable regression model to a healthy non-smoking general population sample from northern Sweden. Further aims were to evaluate the external validity of the obtained reference values on a contemporary sample from south-western Sweden, and to compare them to the Global Lung Function Initiative (GLI) reference values.MethodSex-specific multivariable linear regression models were fitted to the spirometric data of n =501 healthy non-smoking adults aged 22–91 years, with age and height as predictors. The models were extended to allow the scatter around the outcome variable to depend on age, and age-dependent spline functions were incorporated into the models to provide a smooth fit over the entire age range. Mean values and lower limits of normal, defined as the lower 5th percentiles, were derived.ResultThis modelling approach resulted in unbiased estimates of the spirometric outcomes, and the obtained estimates were appropriate not only for the northern Sweden sample but also for the south-western Sweden sample. On average, the GLI reference values for forced expiratory volume in one second (FEV_(1)) and, in particular, forced expiratory vital capacity (FVC) were lower than both the observed values and the new reference values, but higher for the FEV_(1)/FVC ratio.ConclusionThe evaluation based on the sample of healthy non-smokers from northern Sweden show that the Obstructive Lung Disease in Northern Sweden reference values are valid. Furthermore, the evaluation based on the south-western Sweden sample indicates a high external validity. The comparison with GLI brought further evidence to the consensus that, when available, appropriate local population-specific reference values may be preferred.
机译：背景技术通常通过将观察到的肺活量值与相应的参考值进行比较来识别肺功能异常。建议经常评估和更新肺活量测定的参考值。这项研究的目的是通过对瑞典北部健康的非吸烟普通人群样本进行多变量回归模型拟合，以估计瑞典成年人的新参考值。进一步的目的是评估瑞典西南部当代样本获得的参考值的外部有效性，并将其与全球肺功能倡议（GLI）参考值进行比较.MethodSex特定的多元线性回归模型适用于n = 501名22-91岁的健康非吸烟成年人的肺活量数据，年龄和身高作为预测指标。扩展了模型以允许结果变量周围的散布取决于年龄，并且将年龄相关的样条函数合并到模型中以在整个年龄范围内提供平稳拟合。结果得出了平均值和平均值下限（定义为较低的第5个百分位数）。结果此建模方法得出了肺功能测定结果的无偏估计，并且所得估计值不仅适用于瑞典北部样本，还适用于西南样本瑞典样品。平均而言，一秒钟的强制呼气量的GLI参考值（FEV_（1）），尤其是强制呼气的肺活量（FVC）低于观察值和新参考值，但高于FEV_ （1）/ FVC比值。结论基于瑞典北部健康非吸烟者样本的评估表明，瑞典北部阻塞性肺疾病参考值有效。此外，基于瑞典西南部样本的评估显示出较高的外部有效性。与GLI的比较为共识提供了进一步的证据，即在可能的情况下，可能会首选合适的本地特定人群参考值。

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