RT Journal Article
SR Electronic
T1 Assessment of Global Lung Function Initiative (GLI) reference equations for diffusing capacity in relation to respiratory burden in the Swedish CArdioPulmonary bioImage Study (SCAPIS)
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1901995
DO 10.1183/13993003.01995-2019
VO 56
IS 2
A1 Andrei Malinovschi
A1 Xingwu Zhou
A1 Björn Bake
A1 Göran Bergström
A1 Anders Blomberg
A1 Jonas Brisman
A1 Kenneth Caidahl
A1 Gunnar Engström
A1 Maria J. Eriksson
A1 Andreas Frølich
A1 Christer Janson
A1 Kjell Jansson
A1 Jenny Vikgren
A1 Anne Lindberg
A1 Robert Linder
A1 Maria Mannila
A1 Hans L. Persson
A1 C. Magnus Sköld
A1 Kjell Torén
A1 Carl J. Östgren
A1 Per Wollmer
A1 Jan E. Engvall
YR 2020
UL http://erj.ersjournals.com/content/56/2/1901995.abstract
AB 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.The LLN for DLCO is above the GLI LLN in never-smoking, middle-aged Swedish adults. Individuals with DLCO above the GLI LLN but below the SCAPIS LLN had an increased burden of respiratory disease, suggesting clinical implications for the present findings. https://bit.ly/39B455B