Stitching and switching: the impact of discontinuous lung function reference equations: Figure 1–

BackgroundMeasurement of lung volumes across the life course is critical to the diagnosis and management of lung disease. The aim of the study was to use the Global Lung Function Initiative methodology to develop all-age multi-ethnic reference equations for lung volume indices determined using body plethysmography and gas dilution techniques.MethodsStatic lung volume data from body plethysmography and gas dilution techniques from individual, healthy participants were collated. Reference equations were derived using the LMS (lambda-mu-sigma) method and the generalised additive models of location shape and scale programme in R. The impact of measurement technique, equipment type and being overweight or obese on the derived lung volume reference ranges was assessed.ResultsData from 17 centres were submitted and reference equations were derived from 7190 observations from participants of European ancestry between the ages of 5 and 80 years. Data from non-European ancestry populations were insufficient to develop multi-ethnic equations. Measurements of functional residual capacity (FRC) collected using plethysmography and dilution techniques showed physiologically insignificant differences and were combined. Sex-specific reference equations including height and age were developed for total lung capacity (TLC), FRC, residual volume (RV), inspiratory capacity, vital capacity, expiratory reserve volume and RV/TLC. The derived equations were similar to previously published equations for FRC and TLC, with closer agreement during childhood and adolescence than in adulthood.ConclusionsGlobal Lung Function Initiative reference equations for lung volumes provide a generalisable standard for reporting and interpretation of lung volumes measurements in individuals of European ancestry.

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The impact of changing to the Global Lung Function Initiative reference equations for transfer factor in paediatrics

ERJ Open Research ◽

10.1183/23120541.00412-2020 ◽

2020 ◽

pp. 00412-2020

Author(s):

Paul D. Burns ◽

James Y. Paton

Keyword(s):

Carbon Monoxide ◽

Lung Function ◽

Paediatric Patient ◽

Transfer Factor ◽

Reference Equations ◽

The Difference ◽

Predicted Values ◽

Age Range ◽

The Impact ◽

Interpretation Of Results

The Global Lung Function Initiative (GLI) all age reference equations for carbon monoxide transfer factor were published in 2017 and endorsed by the ERS/ATS. In order to understand the impact of these new reference equations on the interpretation of results in children referred from haematology and oncology paediatric services, we retrospectively analysed transfer factor results from any paediatric patient referred from haematology oncology in the period 2010–2018. We examined TLCO, KCO and VA from 241 children (age range; 7–18, 130 male). The predicted values from Rosenthal and GLI were plotted against height. The difference in interpretation of results was analysed by looking at the percentage of patients <LLN for each parameter. Overall, the Rosenthal predicted values for TLCO were higher than GLI. Predicted KCO using Rosenthal was higher in all observations. In contrast, the Rosenthal predicted VA was generally lower than the GLI value. The GLI predicted values for transfer factor show considerable differences compared with currently used paediatric UK reference values, differences that will have a significant impact on interpretation of results.

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The impact of stepwise withdrawal of inhaled corticosteroids on lung function in COPD patients receiving dual bronchodilation: WISDOM study

Pneumologie ◽

10.1055/s-0035-1544631 ◽

2015 ◽

Vol 69 (S 01) ◽

Author(s):

H Watz ◽

P Calverley ◽

P Chanez ◽

R Dahl ◽

M Decramer ◽

...

Keyword(s):

Lung Function ◽

Inhaled Corticosteroids ◽

Copd Patients ◽

Dual Bronchodilation ◽

The Impact

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Impact of Lung Biopsy on Lung Function in Idiopathic Pulmonary Fibrosis

Respiration ◽

10.1159/000509557 ◽

2020 ◽

pp. 1-8

Author(s):

Pierre-Henri Aussedat ◽

Nader Chebib ◽

Kais Ahmad ◽

Jean-Charles Glerant ◽

Gabrielle Drevet ◽

...

Keyword(s):

Lung Function ◽

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Forced Vital Capacity ◽

Lung Biopsy ◽

Vital Capacity ◽

Forced Expiratory Volume ◽

Surgical Lung Biopsy ◽

Before And After ◽

The Impact

Background: Video-assisted surgical lung biopsy (SLB) is performed in 10–30% of cases to establish the diagnosis of idiopathic pulmonary fibrosis (IPF). Objectives: The aim of the study was to analyze the impact of SLB on lung function in patients eventually diagnosed with IPF. Methods: This is an observational, retrospective, monocentric study of all consecutive patients eventually diagnosed with IPF in multidisciplinary discussion who underwent SLB over 10 years in a specialized center. The primary end point was the variation in forced vital capacity (FVC) before and after the SLB. The secondary end points were the variations in forced expiratory volume in one second (FEV1), total lung capacity (TLC), carbon monoxide diffusion capacity (DLCO), and morbidity and mortality associated with the SLB. Results: In 118 patients who underwent SLB and were diagnosed with IPF, a relative decrease in FVC of 4.8% (p < 0.001) was found between measurements performed before and after the procedure. The mean FVC decrease was 156 ± 386 mL in an average period of 185 days, representing an annualized decline of 363 ± 764 mL/year. A significant decrease was also observed after SLB in FEV1, TLC, and DLCO. Complications within 30 days of SLB occurred in 14.4% of patients. Two patients (1.7%) died within 30 days, where one of them had poor lung function. Survival at 1 year was significantly poorer in patients with FVC <50% at baseline. Conclusion: In this uncontrolled study in patients ultimately diagnosed with IPF, SLB was followed by a significant decline in FVC, which appears to be numerically greater than the average decline in the absence of treatment in the literature. Summary at a Glance: This study evaluated the change in lung function in 118 consecutive patients diagnosed with idiopathic pulmonary fibrosis by surgical lung biopsy. Forced vital capacity decreased by 156 ± 386 mL in a mean of 185 days between the last measurement before and first measurement after biopsy, representing an annualized decline of 363 ± 764 mL/year.

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Global Lung Function Initiative 2012 reference equations for spirometry in the Norwegian population

European Respiratory Journal ◽

10.1183/13993003.00443-2016 ◽

2016 ◽

Vol 48 (6) ◽

pp. 1602-1611 ◽

Cited By ~ 33

Author(s):

Arnulf Langhammer ◽

Ane Johannessen ◽

Turid L. Holmen ◽

Hasse Melbye ◽

Sanja Stanojevic ◽

...

Keyword(s):

Lung Function ◽

Reference Values ◽

Vital Capacity ◽

Population Based ◽

Forced Expiratory Volume ◽

Female Adolescents ◽

Norwegian Population ◽

Reference Equations ◽

Z Scores ◽

Lower Limit Of Normal

We studied the fit of the Global Lung Function Initiative (GLI) all-age reference values to Norwegians, compared them with currently used references (European Community for Steel and Coal (ECSC) and Zapletal) and estimated the prevalence of obstructive lung disease.Spirometry data collected in 30 239 subjects (51.7% females) aged 12–90 years in three population-based studies were converted to z-scores.We studied healthy non-smokers comprising 2438 adults (57.4% females) aged 20–90 years and 8725 (47.7% female) adolescents aged 12–19 years. The GLI-2012 prediction equations fitted the Norwegian data satisfactorily. Median±sd z-scores were respectively 0.02±1.03, 0.01±1.04 and −0.04±0.91 for forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC in males, and −0.01±1.02, 0.07±0.97 and −0.21±0.82 in females. The ECSC and Zapletal references significantly underestimated FEV1 and FVC. Stricter criteria of obstruction (FEV1/FVC <GLI-2012 lower limit of normal (LLN)) carried a substantially higher risk of obstructive characteristics than FEV1/FVC <0.7 and >GLI-2012 LLN. Corresponding comparison regarding myocardial infarction showed a four-fold higher risk for women.The GLI-2012 reference values fit the Norwegian data satisfactorily and are recommended for use in Norway. Correspondingly, the FEV1/FVC GLI-2012 LLN identifies higher risk of obstructive characteristics than FEV1/FVC <0.7.

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THE IMPACT OF SARCOPENIA DEFINITIONS AND THE ASSOCIATION WITH LUNG FUNCTION IN OLDER AUSTRALIANS

Innovation in Aging ◽

10.1093/geroni/igx004.5133 ◽

2017 ◽

Vol 1 (suppl_1) ◽

pp. 1394-1395

Author(s):

S.C. Yu ◽

T. Nguyen ◽

R. Adams ◽

R. Visvanathan

Keyword(s):

Lung Function ◽

The Impact

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Body mass index status and peripheral airway obstruction in school-age children: a population-based cohort study

Thorax ◽

10.1136/thoraxjnl-2017-210716 ◽

2018 ◽

Vol 73 (6) ◽

pp. 538-545 ◽

Cited By ~ 12

Author(s):

Sandra Ekström ◽

Jenny Hallberg ◽

Inger Kull ◽

Jennifer L P Protudjer ◽

Per Thunqvist ◽

...

Keyword(s):

Body Mass Index ◽

Lung Function ◽

Airway Obstruction ◽

Body Mass ◽

Overweight And Obesity ◽

School Age Children ◽

Childhood And Adolescence ◽

Small Airways ◽

Cross Sectional ◽

The Impact

BackgroundFew large prospective studies have investigated the impact of body mass index (BMI) on lung function during childhood.MethodsUsing data collected between 2002 and 2013, we analysed associations between BMI status and lung function (assessed by spirometry) from 8 to 16 years, as well as cross-sectional associations with small airway function (impulse oscillometry) at 16 years in the BAMSE cohort (n=2889). At 16 years, cross-sectional associations with local and systemic inflammation were investigated by analysing FENO, blood eosinophils and neutrophils.ResultsOverweight and obesity at 8 years were associated with higher FVC, but lower FEV1/FVC ratio at 8 and 16 years. In boys, but not girls, obesity at 8 years was associated with a further reduction in FEV1/FVC between 8 and 16 years. In cross-sectional analyses, overweight and obesity were associated with higher frequency dependence of resistance (R5–20) and larger area under the reactance curve (AX0.5) at 16 years. Increased blood neutrophil counts were seen in overweight and obese girls, but not in boys. No association was found between BMI status and FENO. Persistent, but not transient, overweight/obesity between 8 and 16 years was associated with higher R5–20 and AX0.5 and lower FEV1/FVC (−2.8% (95% CI −4.1 to −1.2) in girls and −2.7% (95% CI −4.4 to −1.1) in boys) at 16 years, compared with persistent normal weight.ConclusionIn childhood and adolescence, overweight and obesity, particularly persistent overweight, were associated with evidence of airway obstruction, including the small airways.

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Avoiding ageism and promoting independence from reference equations in lung function testing of older adults

European Respiratory Journal ◽

10.1183/13993003.00172-2020 ◽

2020 ◽

Vol 55 (3) ◽

pp. 2000172

Author(s):

Johannes A. Luoto ◽

Mats Pihlsgård

Keyword(s):

Older Adults ◽

Lung Function ◽

Lung Function Testing ◽

Reference Equations ◽

Function Testing

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Long-term observational study on the impact of GLP-1R agonists on lung function in diabetic patients

Respiratory Medicine ◽

10.1016/j.rmed.2019.06.015 ◽

2019 ◽

Vol 154 ◽

pp. 86-92 ◽

Cited By ~ 2

Author(s):

Paola Rogliani ◽

Maria Gabriella Matera ◽

Luigino Calzetta ◽

Nicola A. Hanania ◽

Clive Page ◽

...

Keyword(s):

Lung Function ◽

Observational Study ◽

Diabetic Patients ◽

The Impact

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The impact of body mass index, central obesity and physical activity on lung function: results of the EpiHealth study

ERJ Open Research ◽

10.1183/23120541.00214-2020 ◽

2020 ◽

Vol 6 (4) ◽

pp. 00214-2020

Author(s):

Magnus Svartengren ◽

Gui-Hong Cai ◽

Andrei Malinovschi ◽

Jenny Theorell-Haglöw ◽

Christer Janson ◽

...

Keyword(s):

Physical Activity ◽

Body Mass Index ◽

Lung Function ◽

Body Mass ◽

Physical Inactivity ◽

Central Obesity ◽

Forced Expiratory Volume ◽

Normal Weight ◽

Weight Group ◽

The Impact

Study objectivesObesity is often associated with lower lung function; however, the interaction of lung function with central obesity and physical inactivity is less clear. As such, we investigated the effect on lung function of body size (body mass index (BMI)), central obesity (waist circumference (WC)) and self-reported physical activity.MethodsLung function, height, weight and WC were measured in 22 743 participants (12 791 women), aged 45–75 years, from the EpiHealth cohort study. Physical activity, gender and educational level were assessed using a questionnaire.ResultsObesity, central obesity and physical inactivity were all associated with lower forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). However, in participants without central obesity there was an increase in both FEV1 and FVC by BMI (% predicted FVC increasing from median 98%, interquartile range (IQR) 89–110% in underweight participants (BMI <20) to 103%, IQR 94–113% in obese participants (BMI ≥30)). In contrast, there was a decrease in % predicted FVC in participants with central obesity (from 98%, IQR 89–109% in the normal weight group to 95%, IQR 85–105% in the obese weight group). We further found a negative association between physical activity and lung function among those with low and high levels of physical activity (% predicted FEV1 97%, IQR 86–107% versus 103%, IQR 94–113%, respectively and % predicted FVC 96%, IQR 85–106% versus 103%, IQR 94–113%, respectively). All results remained when calculated by z-scores.ConclusionsThe association between BMI and lung function is dependent on the presence of central obesity. Independent of obesity, there is an association between physical activity and lung function.

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