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Validation of the global lung initiative 2012 multi-ethnic spirometric reference equations in healthy urban Zimbabwean 7-13 year-old school children: a cross-sectional observational study.
BMC Pulmonary Medicine ( IF 3.1 ) Pub Date : 2020-02-28 , DOI: 10.1186/s12890-020-1091-4
Tafadzwa Madanhire 1, 2 , Rashida A Ferrand 2, 3 , Engi F Attia 4 , Elopy N Sibanda 5 , Simba Rusakaniko 1 , Andrea M Rehman 6
Affiliation  

BACKGROUND The 2012 Global Lung Function Initiative (GLI2012) provide multi-ethnic spirometric reference equations (SRE) for the 3-95 year-old age range, but Sub-Saharan African populations are not represented. This study aimed to evaluate the fit of the African-American GLI2012 SRE to a population of healthy urban and peri-urban Zimbabwean school-going children (7-13 years). METHODS Spirometry and anthropometry were performed on black-Zimbabwean children recruited from three primary schools in urban and peri-urban Harare, with informed consent and assent. Individuals with a history or current symptoms of respiratory disease or with a body mass index-z score (BMI) < - 2 were excluded. Spirometry z-scores were generated from African-American GLI2012 SRE, which adjust for age, sex, ethnicity and height, after considering all GLI2012 modules. Anthropometry z-scores were generated using the British (1990) reference equations which adjust for age and sex. The African-American GLI2012 z-score distribution for the four spirometry measurements (FVC, FEV1, FEV1/FVC and MMEF) were evaluated across age, height, BMI and school (as a proxy for socioeconomic status) to assess for bias. Comparisons between the African-American GLI2012 SRE and Polgar equations (currently adopted in Zimbabwe) on the percent-predicted derived values were also performed. RESULTS The validation dataset contained acceptable spirometry data from 712 children (344 girls, mean age: 10.5 years (SD 1.81)). The spirometry z-scores were reasonably normally distributed, with all means lower than zero but within the range of ±0.5, indicating a good fit to the African-American GLI2012 SRE. The African-American GLI2012 SRE produced z-scores closest to a normal distribution. Z-scores of girls deviated more than boys. Weak correlations (Pearson's correlation coefficient < 0.2) were observed between spirometry and anthropometry z-scores, and scatterplots demonstrated no systematic bias associated with age, height, BMI or socioeconomic status. The African-American GLI2012 SRE provided a better fit for Zimbabwean paediatric spirometry data than Polgar equations. CONCLUSION The use of African-American GLI2012 SRE in this population could help in the interpretation of pulmonary function tests.

中文翻译:

在健康的津巴布韦城市 7-13 岁学龄儿童中验证全球肺部倡议 2012 多民族肺活量参考方程:一项横断面观察研究。

背景 2012 年全球肺功能倡议 (GLI2012) 提供了 3-95 岁年龄段的多种族肺功能参考方程 (SRE),但没有代表撒哈拉以南非洲人口。本研究旨在评估非洲裔美国人 GLI2012 SRE 对健康的城市和城郊津巴布韦学龄儿童(7-13 岁)人群的适用性。方法 在知情同意和同意的情况下,对从哈拉雷市区和城郊的三所小学招募的津巴布韦黑人儿童进行了肺活量测定和人体测量。有呼吸系统疾病病史或当前症状或身体质量指数-z 评分 (BMI) < - 2 的个体被排除在外。肺活量计 z 分数由非裔美国人 GLI2012 SRE 生成,在考虑所有 GLI2012 模块后根据年龄、性别、种族和身高进行调整。使用针对年龄和性别进行调整的英国 (1990) 参考方程生成人体测量学 z 分数。四项肺功能测量(FVC、FEV1、FEV1/FVC 和 MMEF)的非洲裔美国人 GLI2012 z 分数分布在年龄、身高、BMI 和学校(作为社会经济地位的代表)上进行评估,以评估偏差。还对非裔美国人 GLI2012 SRE 和 Polgar 方程(目前在津巴布韦采用)对百分比预测派生值进行了比较。结果 验证数据集包含来自 712 名儿童(344 名女孩,平均年龄:10.5 岁 (SD 1.81))的可接受的肺活量测定数据。肺量计 z 分数呈合理的正态分布,所有平均值均低于零但在 ±0.5 范围内,表明非常适合非裔美国人 GLI2012 SRE。非裔美国人 GLI2012 SRE 产生的 z 分数最接近正态分布。女孩的 Z 分数比男孩偏离得更多。在肺活量测定法和人体测量学 z 分数之间观察到弱相关性(皮尔逊相关系数 < 0.2),散点图表明没有与年龄、身高、BMI 或社会经济地位相关的系统偏差。非裔美国人 GLI2012 SRE 比 Polgar 方程更适合津巴布韦儿科肺活量测定数据。结论 在该人群中使用非裔美国人 GLI2012 SRE 有助于解释肺功能测试。散点图表明没有与年龄、身高、BMI 或社会经济地位相关的系统性偏差。非裔美国人 GLI2012 SRE 比 Polgar 方程更适合津巴布韦儿科肺活量测定数据。结论 在该人群中使用非裔美国人 GLI2012 SRE 有助于解释肺功能测试。散点图表明没有与年龄、身高、BMI 或社会经济地位相关的系统性偏差。非裔美国人 GLI2012 SRE 比 Polgar 方程更适合津巴布韦儿科肺活量测定数据。结论 在该人群中使用非裔美国人 GLI2012 SRE 有助于解释肺功能测试。
更新日期:2020-04-22
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