Canadian prediction equations of spirometric lung function for Caucasian adults 20 to 90 years of age: results from the Canadian Obstructive Lung Disease (COLD) study and the Lung Health Canadian Environment (LHCE) study

Abstract

Background: Currently, no reference or normative values for spirometry based on a randomly selected Canadian population exist.

Objective: The aim of the present analysis was to construct spirometric reference values for Canadian adults 20 to 90 years of age by combining data collected from healthy lifelong nonsmokers in two population-based studies.

Method: Both studies similarly used random population sampling, conducted using validated epidemiological protocols in the Canadian Obstructive Lung Disease study, and the Lung Health Canadian Environment study. Spirometric lung function data were available from 3042 subjects in the COLD study, which was completed in 2009, and from 2571 subjects in the LHCE study completed in 1995. A total of 844 subjects 40 to 90 years of age, and 812 subjects 20 to 44 years of age, were identified as healthy, asymptomatic, lifelong nonsmokers, and provided normative reference values for spirometry. Multiple regression models were constructed separately for Caucasian men and women for the following spirometric parameters: forced expiratory volume in 1 s (FEV(1)), forced vital capacity (FVC) and FEV(1)⁄FVC ratio, with covariates of height, sex and age. Comparison with published regression equations showed that the best agreement was obtained from data derived from random populations.

Results: The best-fitting regression models for healthy, never-smoking, asymptomatic European-Canadian men and women 20 to 90 years of age were constructed. When age- and height-corrected FEV(1), FVC and FEV(1)⁄FVC ratio were compared with other spirometry reference studies, mean values were similar, with the closest being derived from population-based studies.

Conclusion: These spirometry reference equations, derived from randomly selected population-based cohorts with stringently monitored lung function measurements, provide data currently lacking in Canada.

Figures

Figure 1)

Scatterplots of the spirometric variables forced expiratory volume in 1 s (FEV1) (upper panel) and forced vital capacity (FVC) (lower panel) versus age for men (upper left and lower left) and women (upper right and lower right) from the collated data of the Lung Health and Canadian Environment (LHCE) study (20 to 44 years of age) and the Canadian Obstructive Lung Disease (COLD) study (40 to 90 years of age)

Figure 2)

Predicted forced expiratory volume in 1 s (FEV1) values for healthy men (upper panel) and for healthy women (lower panel) from combined chorts of the COLD and LHCE studies are compared with those from other spirometry reference equations. COLD Canadian Obstructive Lung Disease study; LCHE Lung Health and Canadian Environment study; NHANES National Health and Nutrition Examination Survey