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Cut-off value of FEV1/FEV6 as a surrogate for FEV1/FVC for detecting airway obstruction in a Korean population

Other Titles
 한국인에서 폐쇄성폐질환을 진단하기위해 사용되는 FEV1/FVC를 대체할 수 있는 FEV1/FEV6의 기준값 
Authors
 Kyung Soo Chung  ;  Ji Ye Jung  ;  Moo Suk Park  ;  Young Sam Kim  ;  Se Kyu Kim  ;  Joon Chang  ;  Joo Han Song 
Citation
 INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE, Vol.11(1) : 1957-1963, 2016 
Journal Title
 INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE 
ISSN
 1176-9106 
Issue Date
2016
MeSH
Adult ; Aged ; Airway Obstruction/diagnosis* ; Airway Obstruction/physiopathology ; Area Under Curve ; Female ; Forced Expiratory Volume* ; Humans ; Lung/physiopathology* ; Male ; Middle Aged ; Nutrition Surveys ; Predictive Value of Tests ; Pulmonary Disease, Chronic Obstructive/diagnosis* ; Pulmonary Disease, Chronic Obstructive/physiopathology ; ROC Curve ; Reproducibility of Results ; Republic of Korea ; Spirometry* ; Vital Capacity*
Keywords
airway obstruction ; chronic obstructive pulmonary disease ; forced expiratory volume in 6 seconds ; pulmonary function test
Abstract
BACKGROUND: Forced expiratory volume in 1 second (FEV1)/forced expiratory volume in 6 seconds (FEV6) has been proposed as an alternative to FEV1/forced vital capacity (FVC) for detecting airway obstruction. A fixed cut-off value for FEV1/FEV6 in a Korean population is lacking. We investigated a fixed cut-off for FEV1/FEV6 as a surrogate for FEV1/FVC for detecting airway obstruction. MATERIALS AND METHODS: We used data obtained in the 5 years of the Fifth and Sixth Korean National Health and Nutrition Examination Survey. A total of 14,978 participants aged ≥40 years who underwent spirometry adequately were the study cohort. ""Airway obstruction"" was a fixed cut-off FEV1/FVC <70% according to the Global Initiative for Chronic Obstructive Lung Disease guidelines. We also used European Respiratory Society/Global Lung Initiative 2012 equations for the FEV1/FVC lower limit of normal. RESULTS: Among the 14,978 participants (43.5% male, 56.5% female; mean age: 56.9 years for men and 57.0 years for women), 14.0% had obstructive lung function according to a fixed cut-off FEV1/FVC <70%. Optimal FEV1/FEV6 cut-off for predicting FEV1/FVC <70% was 75% using receiver operating characteristic curve analyses (area under receiver operating characteristic curve =0.989, 95% confidence interval 0.987-0.990). This fixed cut-off of FEV1/FEV6 showed 93.8% sensitivity, 94.8% specificity, 74.7% positive predictive value, 98.9% negative predictive value, and 0.8 Cohen's kappa coefficient. When compared with FEV1/FVC < lower limit of normal, FEV1/FEV6 <75% tended to over-diagnose airflow limitation (just like a fixed cut-off of FEV1/FVC <70%). When grouped according to age and FEV1 (%), FEV1/FEV6 <75% diagnosed more airway obstruction in older participants and mild-moderate stages compared with FEV1/FVC <70%. CONCLUSION: A valid fixed cut-off for detecting airway obstruction in a Korean population is FEV1/FEV6 of 75%, but should be used with caution in older individuals and those with mild-moderate airway obstruction.
Files in This Item:
T201603001.pdf Download
DOI
10.2147/COPD.S113568
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Se Kyu(김세규)
Kim, Young Sam(김영삼) ORCID logo https://orcid.org/0000-0001-9656-8482
Park, Moo Suk(박무석) ORCID logo https://orcid.org/0000-0003-0820-7615
Song, Joo Han(송주한)
Chang, Joon(장준) ORCID logo https://orcid.org/0000-0003-4542-6841
Jung, Kyung Soo(정경수) ORCID logo https://orcid.org/0000-0003-1604-8730
Jung, Ji Ye(정지예) ORCID logo https://orcid.org/0000-0003-1589-4142
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/151856
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