The recent multi-ethnic global lung initiative 2012 (GLI2012) reference values don't reflect contemporary adult's North African spirometry

Helmi Ben Saad, Mohamed Nour El Attar, Khaoula Hadj Mabrouk, Ahmed Ben Abdelaziz, Ahmed Abdelghani, Mohamed Bousarssar, Khélifa Limam, Chiraz Maatoug, Hmida Bouslah, Ameur Charrada, Sonia Rouatbi
Respiratory Medicine 2013, 107 (12): 2000-8

BACKGROUND: The applicability of the recent multi-ethnic reference equations derived by the ERS Global Lung Initiative (ERS/GLI) in interpreting spirometry data in North African adult subjects has not been studied.

OBJECTIVE: To ascertain how well the recent ERS/GLI reference equations fit contemporary adult Tunisian spirometric data.

POPULATION AND METHODS: Spirometric data were recorded from 1192 consecutive spirometry procedures in adults aged 18-60 years. Reference values and lower limits of normality (LLN) were calculated using the local and the ERS/GLI reference equations. Applied definitions: large airway obstructive ventilatory defect (LAOVD): FEV1/FVC < LLN. Tendency to a restrictive ventilatory defect (TRVD): FEV1 and FVC < LLN and FEV1/FVC ≥ LLN. The spirometric profile, according to the two reference equations, was determined. Z-scores for spirometry from North African healthy subjects (n = 489) were calculated. If the average Z-score deviated by <± 0.5 from the overall mean, the ERS/GLI reference equations would be considered as reflective of contemporary Tunisian spirometry.

RESULTS: Using Tunisian reference equations, 71.31%, 6.71% and 19.04% of spirometry records were interpreted as normal, and as having, LAOVD and TRVD, respectively. Using the ERS/GLI reference equations, these figures were respectively, 85.82%, 4.19% and 8.39%. The mean ± SD Z-scores for the contemporary healthy North African subject's data were -0.55 ± 0.87 for FEV1, -0.62 ± 0.86 for FVC and 0.10 ± 0.73 for FEV1/FVC.

CONCLUSION: The present study don't recommend the use of the recent ERS/GLI reference equations to interpret spirometry in North African adult population.

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