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Pulmonary function of healthy Korean children from three independent birth cohorts: Validation of the Global Lung Function Initiative 2012 equation

 Ji Soo Park  ;  Dong In Suh  ;  Yun Jung Choi  ;  Kangmo Ahn  ;  Kyung Won Kim  ;  Youn Ho Shin  ;  So-Yeon Lee  ;  Hyun-Ju Cho  ;  Eun Lee  ;  Gwang Cheon Jang  ;  Ji-Won Kwon  ;  Yong Han Sun  ;  Sung-Il Woo  ;  You-Sook Youn  ;  Kang Seo Park  ;  Myung-Hee Kook  ;  Hwa Jin Cho  ;  Hai Lee Chung  ;  Ja Hyung Kim  ;  Hyung Young Kim  ;  Jin A Jung  ;  Hyang-Ok Woo  ;  Yoon Kyung Choi  ;  Jeong Rim Lee  ;  Young Ah Lee  ;  Choong Ho Shin  ;  Boong Nyun Kim  ;  Johanna I Kim  ;  Kyung-Shin Lee  ;  Youn Hee Lim  ;  Yun-Chul Hong  ;  Soo-Jong Hong 
 PEDIATRIC PULMONOLOGY, Vol.56(10) : 3310-3320, 2021-10 
Journal Title
Issue Date
Birth Cohort* ; Child ; Female ; Forced Expiratory Volume ; Humans ; Lung* ; Male ; Reference Values ; Republic of Korea ; Spirometry ; Vital Capacity
Asian ; Global Lung Function Initiative ; children ; reference equation ; spirometry
Background and objective: Global Lung Function Initiative (GLI) 2012 equations were developed to resolve the age-related disparity in interpreting spirometry results. Local validation of the equation is needed, especially in Northeast Asian children. This study evaluated the GLI equation in Korean children.

Methods: Spirometry indices (FEV1, FVC, FEV1/FVC, and FEF25%-75%) and clinical information were gathered from three population-based birth cohorts. Predicted GLI reference values and z scores of spirometry results were calculated for 1239 healthy children. The mean, standard deviation of z scores were compared with the expected 0 and 1. Probabilities of falling below the lower limit of normal (LLN) (z score: -1.64) were compared with the expected value 5%. GLI z scores were assessed according to low (<-2), normal (≥-2 and ≤2), and high (>2) BMI z score groups.

Results: Mean z scores significantly differed from 0 for FEV1/FVC in males (mean [95% confidence interval]: 0.18 [0.08, 0.27]) and forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) in females (-0.23 [-0.31, -0.15] and -0.26 [-0.36, -0.16], respectively). The standard deviation was larger than 1 for all variables in males and FVC and FEV1/FVC in females. The probability of falling below the LLN was significantly larger than 5% for FEV1 (12.13% [9.64, 14.77]), FVC (15.86% [13.06, 18.81]), and forced expiratory flow at 25%-75% of forced vital capacity (FEF25%-75%) (7.31% [5.29, 9.49]) in males and FVC (11.91% [9.40, 14.60]) in females. FEV1 and FVC z scores increased across low to high body mass index (BMI) groups, and FEV1/FVC decreased from low to high BMI groups.

Conclusion: GLI equations marginally differ from real-world values, which should be considered by pulmonologists in practice or research.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Won(김경원) ORCID logo https://orcid.org/0000-0003-4529-6135
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