TY - JOUR
T1 - Performance of american thoracic society-recommended spirometry reference values in a multiethnic sample of adults the multi-ethnic study of atherosclerosis (MESA) lung study
AU - Hankinson, John L.
AU - Kawut, Steven M.
AU - Shahar, Eyal
AU - Smith, Lewis J.
AU - Stukovsky, Karen Hinckley
AU - Graham Barr, R.
N1 - Funding Information:
Funding/Support: This study was funded by the National Institutes of Health/National Heart, Lung, and Blood Institute [grants R01 HL-077612 and R01 HL-075476 and contracts N01-HC95159-169 ].
PY - 2010/1/1
Y1 - 2010/1/1
N2 - Background: The American Thoracic Society recommends race-specific spirometric reference values from the National Health and Nutrition Survey (NHANES) III for clinical evaluation of pulmonary function in whites, African-Americans, and Mexican-Americans in the United States and a correction factor of 0.94 for Asian-Americans. We aimed to validate the NHANES III reference equations and the correction factor for Asian-Americans in an independent, multiethnic sample of US adults. Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) recruited self-identified non-Hispanic white, African-American, Hispanic, and Asian-American participants aged 45 to 84 years at six US sites. The MESA-Lung Study assessed prebronchodilator spirometry among 3,893 MESA participants who performed acceptable tests, of whom 1,068 were asymptomatic healthy nonsmokers who performed acceptable spirometry. Results: The 1,068 participants were mean age 65 ± 10 years, 60% female, 25% white, 20% African-American, 23% Hispanic, and 32% Asian-American. Observed values of FEV1, FEV6, and FVC among whites, African-Americans, and Hispanics of Mexican origin in MESA-Lung were slightly lower than predicted values based on NHANES III. Observed values among Hispanics of non-Mexican origin were consistently lower. Agreement in classification of participants with air-flow obstruction based on lower limit of normal criteria was good (overall κ = 0.88). For Asian-Americans, a correction factor of 0.88 was more accurate than 0.94. Conclusions: The NHANES III reference equations are valid for use among older adults who are white, African-American, or Hispanic of Mexican origin. Comparison of white and Asian-American participants suggests that a correction factor of 0.88, applied to the predicted and lower limits of normal values, is more appropriate than the currently recommended value of 0.94.
AB - Background: The American Thoracic Society recommends race-specific spirometric reference values from the National Health and Nutrition Survey (NHANES) III for clinical evaluation of pulmonary function in whites, African-Americans, and Mexican-Americans in the United States and a correction factor of 0.94 for Asian-Americans. We aimed to validate the NHANES III reference equations and the correction factor for Asian-Americans in an independent, multiethnic sample of US adults. Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) recruited self-identified non-Hispanic white, African-American, Hispanic, and Asian-American participants aged 45 to 84 years at six US sites. The MESA-Lung Study assessed prebronchodilator spirometry among 3,893 MESA participants who performed acceptable tests, of whom 1,068 were asymptomatic healthy nonsmokers who performed acceptable spirometry. Results: The 1,068 participants were mean age 65 ± 10 years, 60% female, 25% white, 20% African-American, 23% Hispanic, and 32% Asian-American. Observed values of FEV1, FEV6, and FVC among whites, African-Americans, and Hispanics of Mexican origin in MESA-Lung were slightly lower than predicted values based on NHANES III. Observed values among Hispanics of non-Mexican origin were consistently lower. Agreement in classification of participants with air-flow obstruction based on lower limit of normal criteria was good (overall κ = 0.88). For Asian-Americans, a correction factor of 0.88 was more accurate than 0.94. Conclusions: The NHANES III reference equations are valid for use among older adults who are white, African-American, or Hispanic of Mexican origin. Comparison of white and Asian-American participants suggests that a correction factor of 0.88, applied to the predicted and lower limits of normal values, is more appropriate than the currently recommended value of 0.94.
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U2 - 10.1378/chest.09-0919
DO - 10.1378/chest.09-0919
M3 - Article
C2 - 19741060
AN - SCOPUS:74849125941
SN - 0012-3692
VL - 137
SP - 138
EP - 145
JO - CHEST
JF - CHEST
IS - 1
ER -