Dataset Information

Reference equations for spirometry in healthy Asian children aged 5 to 18 years in Taiwan.

ABSTRACT: Background and objective:This study aimed to establish reference equations for spirometry in healthy Taiwanese children and assess the applicability of the Global Lung Function Initiative (GLI)-2012 equations to Taiwanese children. Methods:Spirometric data collected from 757 healthy Taiwanese children aged 5 to 18 years in a population-based cohort study. Prediction equations derived using linear regression and the generalized additive models for location, scale and shape (GAMLSS) method, respectively. Results:The GLI-2012 South East Asian equations did not provide a close fit with mean ± standard error z-scores of -0.679 ± 0.030 (FVC), -0.186 ± 0.044 (FEV1), -0.875 ± 0.049 (FEV1/FVC ratio) and -2.189 ± 0.063 (FEF25-75) for girls; and 0.238 ± 0.059, -0.061 ± 0.053, -0.513 ± 0.059 and -1.896 ± 0.077 for boys. The proposed GAMLSS models took age, height, and weight into account. GAMLSS models for boys and girls captured the characteristics of spirometric data in the study population closely in contrast to the linear regression models and the GLI-2012 equations. Conclusion:This study provides up-to-date reference values for spirometry using GAMLSS modeling in healthy Taiwanese children aged 5 to 18 years. Our study provides evidence that the GLI-2012 reference equations are not properly matched to spirometric data in a contemporary Taiwanese child population, indicating the urgent need for an update of GLI reference values by inclusion of more data of non-Caucasian decent.

SUBMITTER: Chang SM

PROVIDER: S-EPMC6835053 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Reference equations for spirometry in healthy Asian children aged 5 to 18 years in Taiwan.

Chang Sheng-Mao SM Tsai Hui-Ju HJ Tzeng Jung-Ying JY Yeh Kuo-Wei KW Chen Li-Chen LC Lai Shen-Hao SH Liao Sui-Ling SL Hua Man-Chin MC Tsai Ming-Han MH Huang Jing-Long JL Yao Tsung-Chieh TC

The World Allergy Organization journal 20191028 11

<h4>Background and objective</h4>This study aimed to establish reference equations for spirometry in healthy Taiwanese children and assess the applicability of the Global Lung Function Initiative (GLI)-2012 equations to Taiwanese children.<h4>Methods</h4>Spirometric data collected from 757 healthy Taiwanese children aged 5 to 18 years in a population-based cohort study. Prediction equations derived using linear regression and the generalized additive models for location, scale and shape (GAMLSS) ...[more]

PMID: 31709028

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Project description:BackgroundThe six-minute walk test (6MWT) is a safe, simple, inexpensive tool for evaluating the functional exercise capacity of patients with chronic respiratory disease. However, there is a lack of standard reference equations for the six-minute walk distance (6MWD) in the healthy Chinese population aged 18-59 years.AimsThe purposes of the present study were as follows: 1) to measure the anthropometric data and walking distance of a sample of healthy Chinese Han people aged 18-59 years; 2) to construct reference equations for the 6MWD; 3) to compare the measured 6MWD with previously published equations.MethodThe anthropometric data, demographic information, lung function, and walking distance of Chinese adults aged 18-59 years were prospectively measured using a standardized protocol. We obtained verbal consent from all the subjects before the test, and the study design was approved by the ethics committee of Wenzhou People's Hospital. The 6MWT was performed twice, and the longer distance was used for further analysis.ResultsA total of 643 subjects (319 females and 324 males) completed the 6MWT, and average walking distance was 601.6±55.51 m. The walking distance was compared between females and males (578±49.85 m vs. 623±52.53 m; p < 0.0001) and between physically active subjects and sedentary subjects (609.3±56.17 m vs. 592±53.23 m; p < 0.0001). Pearson's correlation indicated that the 6MWD was significantly correlated with various demographic and the 6MWT variables, such as age, height, weight, body mass index (BMI), heart rate after the test and the difference in the heart rate before and after the test. Stepwise multiple regression analysis showed that age and height were independent predictors associated with the 6MWD. The reference equations from white, Canadian and Chilean populations tended to overestimate the walking distance in our subjects, while Brazilian and Arabian equations tended to underestimate the walking distance. There was no significant difference in the walking distance between Korean reference equations and the results of the current study.ConclusionIn summary, age and height were the most significant predictors of the 6MWD, and regression equations could explain approximately 34% and 28% of the distance variance in the female and male groups, respectively.

Project description:BackgroundThe number of children with obesity has increased in Saudi Arabia, which is a significant public health concern. Early diagnosis of childhood obesity and screening of the prevalence is needed using a simple in situ method. This study aims to generate statistical equations to predict body fat percentage (BF%) for Saudi children by employing machine learning technology and to establish gender and age-specific body fat reference range.MethodsData was combined from two cross-sectional studies conducted in Saudi Arabia for 1,292 boys and girls aged 8-12 years. Body fat was measured in both studies using bio-electrical impedance analysis devices. Height and weight were measured and body mass index was calculated and classified according to CDC 2,000 charts. A total of 603 girls and 374 boys were randomly selected for the learning phase, and 153 girls and 93 boys were employed in the validation set. Analyses of different machine learning methods showed that an accurate, sensitive model could be created. Two regression models were trained and fitted with the construction samples and validated. Gradient boosting algorithm was employed to achieve a better estimation and produce the equations, then the root means squared error (RMSE) equation was performed to decrease the error. Body fat reference ranges were derived for children aged 8-12 years.ResultsFor the gradient boosting models, the predicted fat percentage values were more aligned with the true value than those in regression models. Gradient boosting achieved better performance than the regression equation as it combined multiple simple models into a single composite model to take advantage of that weak classifier. The developed predictive model archived RMSE of 3.12 for girls and 2.48 boys. BF% and Fat mass index charts were presented in which cut-offs for 5th, 75th and 95th centiles are used to define 'under-fat', 'normal', 'overfat' and 'subject with obesity'.ConclusionMachine learning models could represent a significant advancement for investigators studying adiposity-related issues in children. These models and newly developed centile charts could be useful tools for the estimation and classification of BF%.

Project description:Background:Use of different spirometry reference equations can lead to misinterpretation of spirometry results. Currently, no study has been carried out to determine if there is any discordance between the interpretation of spirometry data using the Global Lungs Initiative (GLI) 2012, the Third National Health and Nutrition Examination Survey (NHANES III), the Knudson, and the Siriraj reference equations in Thai people. Therefore, this study aimed to determine differences and agreements regarding spirometry results using the GLI2012, NHANES III, Knudson, and Siriraj reference equations in a Thai population. Methods:A retrospective study was carried out using 2,492 spirometry results from Thai people (age ranged 8-80 years old) who were referred by their physicians for spirometry testing at the Lung Health Center, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand between January 2005 and December 2015. The spirometry results were interpreted using four reference equations. Respiratory function patterns were classified as normal, spirometric restriction, obstruction, or mixed defect. The severity of abnormal patterns were classified as mild, moderate, moderately severe, severe or very severe. A Nominal Analysis of Variance (NANOVA) test was used to analyze differences in diagnosis and classification for the degree of severity. The Kappa statistic was used to determine agreements of spirometry results between four reference equations. Results:The differentiation in both spirometry diagnosis and the severity classification were significant across the four reference equations (P<0.001). However, the levels of agreement among the four reference equations were moderate to good (Kappa values ranged from 0.56 to 0.77 for the diagnosis and 0.67 to 0.82 for the severity). Conclusions:The results of this study suggest that the use of the GLI2012, NHANES III, Knudson, and Siriraj reference equations alters the interpretation of spirometry data in this population of Thai adults.

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Reference equations for spirometry in healthy Asian children aged 5 to 18 years in Taiwan.

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Reference equations for spirometry in healthy Asian children aged 5 to 18 years in Taiwan.

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