Abstract
Rationale: Accurate reference values for spirometry are important because the results are used for diagnosing common chronic lung diseases such as asthma and chronic obstructive pulmonary disease, estimating physiologic impairment, and predicting all-cause mortality. Reference equations have been established for Mexican Americans but not for others with Hispanic/Latino backgrounds. Objectives: To develop spirometry reference equations for adult Hispanic/Latino background groups in the United States. Methods: The HCHS/SOL (Hispanic Community Health Study/Study of Latinos) recruited a population-based probability sample of 16,415 Hispanics/Latinos aged 18-74 years living in the Bronx, Chicago, Miami, and San Diego. Participants self-identified as being of Puerto Rican, Cuban, Dominican, Mexican, or Central or South American background. Spirometry was performed using standardized methods with central quality control monitoring. Spirometric measures from a subset of 6,425 never-smoking participants without respiratory symptoms or disease were modeled as a function of sex, age, height, and Hispanic/Latino background to produce background-specific reference equations for the predicted value and lower limit of normal. Measurements and Main Results: Dominican and Puerto Rican Americans had substantially lower predicted and lower limit of normal values for FVCand FEV1 than those in other Hispanic/Latino background groups and also than Mexican American values from NHANES III (Third National Health and Nutrition Examination Survey). Conclusions: For patients of Dominican and Puerto Rican background who present with pulmonary symptoms in clinical practice, use of background-specific spirometry reference equations may provide more appropriate predicted and lower limit of normal values, enabling more accurate diagnoses of abnormality and physiologic impairment.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 993-1003 |
| Number of pages | 11 |
| Journal | American journal of respiratory and critical care medicine |
| Volume | 196 |
| Issue number | 8 |
| DOIs | |
| State | Published - Oct 15 2017 |
Funding
*Current address for L.L. is U.S. Food and Drug Administration, Silver Spring, Maryland. †T.K.A. died prior to manuscript acceptance. ‡P.E. is currently retired. xCurrent address for A.N. is Memorial Sloan Kettering Cancer Center, New York, New York. The HCHS/SOL (Hispanic Community Health Study/Study of Latinos) was performed as a collaborative study supported by contracts from the NHLBI to the University of North Carolina (N01-HC65233), the University of Miami (N01-HC65234), Albert Einstein College of Medicine (N01-HC65235), Northwestern University (N01-HC65236), and San Diego State University (N01-HC65237). The following institutes, centers, or offices contribute to the HCHS/SOL through a transfer of funds to the NHLBI: National Center on Minority Health and Health Disparities, the National Institute on Deafness and Other Communication Disorders, the National Institute of Dental and Craniofacial Research, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of Neurological Disorders and Stroke, and the Office of Dietary Supplements. Investigators from the NHLBI of the National Institutes of Health were involved in the design and conduct of the study; in the collection, analysis, and interpretation of the data; and in the review and approval of the manuscript.
Keywords
- Hispanic/Latino
- Reference standards
- Spirometry
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Critical Care and Intensive Care Medicine