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Regional variations in longitudinal pulmonary function: A comparison of Hispanic and non‐Hispanic subjects with cystic fibrosis in the United States
Author(s) -
McGarry Meghan E.,
Neuhaus John M.,
Nielson Dennis W.,
Ly Ngoc P.
Publication year - 2019
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.24377
Subject(s) - medicine , cystic fibrosis , pulmonary function testing , lung function , pulmonary fibrosis , fibrosis , lung
Background Hispanic subjects with cystic fibrosis (CF) have increased morbidity and mortality than non‐Hispanic white subjects. The ethnic disparity in mortality varies by region. Factors influencing pulmonary function vary by both ethnicity and region. Objective To determine if the ethnic difference in pulmonary function varies by region. Methods This retrospective cohort study compared differences in longitudinal pulmonary function (percent‐predicted forced vital capacity [FVC], forced expiratory volume in 1 second [FEV 1 ], forced expiratory flow at 25% to 75% [FEF 25‐75 ], FEV 1 /FVC, and FEV 1 decline) between Hispanic and non‐Hispanic white subjects with CF by Census region of the United States (West, South, Midwest, and Northeast). Subjects were of ages 6 to 25 years and in the CF Foundation Patient Registry from 2008 to 2013. We used linear mixed effects models with subject‐specific slopes and intercepts, adjusting for 14 demographic and clinical variables. Results Of 14 932 subjects, 1433 (9.6%) were Hispanic and 13 499 (90.4%) were non‐Hispanic white. Hispanic subjects’ FEV 1 was 9.0% (8.3%‐9.8%) lower than non‐Hispanic white subjects in the West, while Hispanic subjects’ FEV 1 was only 4.0% (3.0%‐5.0%) lower in the Midwest, 4.4% (3.1%‐5.7%) lower in the Northeast, and 4.4% (3.2%‐5.5%) lower in the South. Similarly, FVC and FEF 25‐75 were lower among Hispanic subjects compared to non‐Hispanic white subjects in all US regions, with the biggest differences in the West. Only in the West was FEV 1 /FVC significantly lower in Hispanic subjects (−0.019; −0.022 to −0.015). FEV 1 decline was not significantly different between ethnicities in any region. Conclusions In CF, Hispanic subjects have lower pulmonary function than non‐Hispanic white subjects in all geographic regions with the largest difference in occurring in the West.