scholarly journals Effects of adopting the Global Lung Function Initiative 2017 reference equations on the interpretation of carbon monoxide transfer factor

2020 ◽  
Vol 55 (5) ◽  
pp. 1901905
Author(s):  
Danny J. Brazzale ◽  
Leigh M. Seccombe ◽  
Liam Welsh ◽  
Celia J. Lanteri ◽  
Claude S. Farah ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Lung Function ◽  
Transfer Factor ◽  
Teaching Hospitals ◽  
Younger Adults ◽  
Adult Females ◽  
Reference Set ◽  
Reference Equations ◽  
Lower Limit Of Normal ◽  
A Current

The recently published Global Lung Function Initiative (GLI) carbon monoxide transfer factor (TLCO) reference equations provide an opportunity to adopt a current, all-age, widely applicable reference set. The aim of this study was to document the effect of changing to GLI from commonly utilised reference equations on the interpretation of TLCO results.33 863 TLCO results (48% female, 88% Caucasian, n=930 aged <18 years) from clinical pulmonary function laboratories within three Australian teaching hospitals were analysed. The lower limit of normal (LLN) and proportion of patients with a TLCO below this value were calculated using GLI and other commonly used reference equations.The average TLCO LLN for GLI was similar or lower than the other equations, with the largest difference seen for Crapo equations (median: −1.25, IQR: −1.64, −0.86 mmol·min−1·kPa−1). These differences resulted in altered rates of reduced TLCO for GLI particularly for adults (+1.9% versus Miller to −27.6% versus Crapo), more so than for children (−0.8% versus Kim to −14.2% versus Cotes). For adults, the highest raw agreement for GLI was with Miller equations (94.7%), while for children it was with Kim equations (98.1%). Results were reclassified from abnormal to normal more frequently for younger adults, and for adult females, particularly when moving from Roca to GLI equations (30% of females versus 16% of males).The adoption of GLI TLCO reference equations in adults will result in altered interpretation depending on the equations previously used and to a greater extent in adult females. The effect on interpretation in children is less significant.

Global lung function initiative: Reference equations for the transfer factor for carbon monoxide (TLCO)

2016 ◽  
Author(s):  
Sanja Stanojevic ◽  
Brian Grham ◽  
Brendan Cooper ◽  
Bruce Thompson ◽  
Kim Carter ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Lung Function ◽  
Transfer Factor ◽  
Reference Equations

Childhood pneumonia, pleurisy and lung function: a cohort study from the first to sixth decade of life

Thorax ◽  
2019 ◽  
Vol 75 (1) ◽  
pp. 28-37 ◽  
Author(s):  
Jennifer L Perret ◽  
Caroline J Lodge ◽  
Adrian J Lowe ◽  
David P Johns ◽  
Bruce R Thompson ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Lung Function ◽  
Lower Limit ◽  
Transfer Factor ◽  
Study Cohort ◽  
Z Score ◽  
Lung Volumes ◽  
Current Asthma ◽  
Childhood Pneumonia ◽  
Lower Limit Of Normal

IntroductionAdult spirometry following community-acquired childhood pneumonia has variably been reported as showing obstructive or non-obstructive deficits. We analysed associations between doctor-diagnosed childhood pneumonia/pleurisy and more comprehensive lung function in a middle-aged general population cohort born in 1961.MethodsData were from the prospective population-based Tasmanian Longitudinal Health Study cohort. Analysed lung function was from ages 7 years (prebronchodilator spirometry only, n=7097), 45 years (postbronchodilator spirometry, carbon monoxide transfer factor and static lung volumes, n=1220) and 53 years (postbronchodilator spirometry and transfer factor, n=2485). Parent-recalled histories of doctor-diagnosed childhood pneumonia and/or pleurisy were recorded at age 7. Multivariable linear and logistic regression were used.ResultsAt age 7, compared with no episodes, childhood pneumonia/pleurisy-ever was associated with reduced FEV1:FVC for only those with current asthma (beta-coefficient or change in z-score=−0.20 SD, 95% CI −0.38 to –0.02, p=0.028, p interaction=0.036). At age 45, for all participants, childhood pneumonia/pleurisy-ever was associated with a restrictive pattern: OR 3.02 (1.5 to 6.0), p=0.002 for spirometric restriction (FVC less than the lower limit of normal plus FEV1:FVC greater than the lower limit of normal); total lung capacity z-score −0.26 SD (95% CI −0.38 to –0.13), p<0.001; functional residual capacity −0.16 SD (−0.34 to –0.08), p=0.001; and residual volume −0.18 SD (−0.31 to –0.05), p=0.008. Reduced lung volumes were accompanied by increased carbon monoxide transfer coefficient at both time points (z-score +0.29 SD (0.11 to 0.49), p=0.001 and +0.17 SD (0.04 to 0.29), p=0.008, respectively).DiscussionFor this community-based population, doctor-diagnosed childhood pneumonia and/or pleurisy were associated with obstructed lung function at age 7 for children who had current asthma symptoms, but with evidence of ‘smaller lungs’ when in middle age.

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

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.

Effect of corrected GLI reference equations on carbon monoxide transfer factor interpretation

2021 ◽  
pp. 2004459
Author(s):  
Warren R. Ruehland ◽  
Celia J. Lanteri ◽  
Pam Matsas ◽  
Danny J. Brazzale
Keyword(s):  
Carbon Monoxide ◽  
Transfer Factor ◽  
Reference Equations

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

2016 ◽  
Vol 48 (6) ◽  
pp. 1602-1611 ◽  
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.

Assessment of Global Lung Function Initiative (GLI) reference equations for diffusing capacity in relation to respiratory burden in the Swedish CArdioPulmonary bioImage Study (SCAPIS)

2020 ◽  
Vol 56 (2) ◽  
pp. 1901995 ◽  
Author(s):  
Andrei Malinovschi ◽  
Xingwu Zhou ◽  
Björn Bake ◽  
Göran Bergström ◽  
Anders Blomberg ◽  
...  
Keyword(s):  
Lung Function ◽  
Reference Values ◽  
Airflow Limitation ◽  
Diffusing Capacity ◽  
High Resolution Computed Tomography ◽  
Swedish Population ◽  
Reference Equations ◽  
Lms Method ◽  
Never Smokers ◽  
Lower Limit Of Normal

The Global Lung Function Initiative (GLI) has recently published international reference values for diffusing capacity of the lung for carbon monoxide (DLCO). Lower limit of normal (LLN), i.e. the 5th percentile, usually defines impaired DLCO. We examined if the GLI LLN for DLCO differs from the LLN in a Swedish population of healthy, never-smoking individuals and how any such differences affect identification of subjects with respiratory burden.Spirometry, DLCO, chest high-resolution computed tomography (HRCT) and questionnaires were obtained from the first 15 040 participants, aged 50–64 years, of the Swedish CArdioPulmonary bioImage Study (SCAPIS). Both GLI reference values and the lambda-mu-sigma (LMS) method were used to define the LLN in asymptomatic never-smokers without respiratory disease (n=4903, of which 2329 were women).Both the median and LLN for DLCO from SCAPIS were above the median and LLN from the GLI (p<0.05). The prevalence of DLCO <GLI LLN (and also <SCAPIS LLN) was 3.9%, while the prevalence of DLCO >GLI LLN but <SCAPIS LLN was 5.7%. Subjects with DLCO >GLI LLN but <SCAPIS LLN (n=860) had more emphysema (14.3% versus 4.5%, p<0.001), chronic airflow limitation (8.5% versus 3.9%, p<0.001) and chronic bronchitis (8.3% versus 4.4%, p<0.01) than subjects (n=13 600) with normal DLCO (>GLI LLN and >SCAPIS LLN). No differences were found with regard to physician-diagnosed asthma.The GLI LLN for DLCO is lower than the estimated LLN in healthy, never-smoking, middle-aged Swedish adults. Individuals with DLCO above the GLI LLN but below the SCAPIS LLN had, to a larger extent, an increased respiratory burden. This suggests clinical implications for choosing an adequate LLN for studied populations.

Reference Equations for Lung Function, Lung Volumes, and Carbon Monoxide Diffusing Capacity of Healthy Never Smoking Adults Aged 18-91 Year

CHEST Journal ◽  
2011 ◽  
Vol 140 (4) ◽  
pp. 678A
Author(s):  
Pavlos Michailopoulos ◽  
Paraskevi Argiropoulou ◽  
Ioannis Kioumis ◽  
Theofilos Pechlivanidis ◽  
Dionisios Spyratos ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Lung Function ◽  
Diffusing Capacity ◽  
Lung Volumes ◽  
Reference Equations

scholarly journals Airway obstruction can be better predicted using Global Lung Function Initiative spirometry reference equations in Marfan syndrome

2021 ◽  
Author(s):  
A. M. Kolonics-Farkas ◽  
Z. Kovats ◽  
A. Bohacs ◽  
B. Odler ◽  
K. Benke ◽  
...  
Keyword(s):  
Lung Function ◽  
Airway Obstruction ◽  
Marfan Syndrome ◽  
Genetic Disorder ◽  
Young Patients ◽  
Forced Expiratory Volume ◽  
Lower Lung ◽  
Reference Equations ◽  
Asymptomatic Adult ◽  
Lower Limit Of Normal

AbstractMarfan syndrome is a genetic disorder of the connective tissue, including involvement of the lungs.Pulmonary function test was performed in 32 asymptomatic adult Marfan patients using European Community for Coal and Steel (ECCS) and Global Lung Function Initiative (GLI) reference values.Using GLI equations for reference, significantly lower lung function values were noted for forced vital capacity (FVC) (87.0 ± 16.6% vs. 97.1 ± 16.9%; P < 0.01) and forced expiratory volume in the first second (FEV1) (79.6 ± 18.9% vs. 88.0 ± 19.1%; P < 0.01) predicted compared to ECCS. Obstructive ventilatory pattern was present in 25% of the cases when calculating with GLI lower limit of normal (LLN), and it was significantly more common in men as compared to women (n = 6, 50% vs. n = 2, 10%; P = 0.03).GLI is more suitable to detect early ventilatory changes including airway obstruction in young patients with special anatomic features, and should be used as a standard way of evaluation in asymptomatic Marfan population.

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