Open AccessAssessing the applicability of the new Global Lung Function Initiative reference values for the diffusing capacity of the lung for carbon monoxide in a large population set
Author(s) -
Pierre-Marie Wardyn,
Virginie de Broucker,
Cécile Chenivesse,
Annie Sobaszek,
R. Van Den Bulck,
Thierry Pérez,
Jean-Louis Edmé,
Sébastien Hulo
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0245434
Subject(s) - medicine , diffusing capacity , population , lung volumes , chronic bronchitis , lung , pulmonary function testing , asthma , lung function , environmental health
Background The single-breath diffusing capacity of the lung for carbon monoxide ( D LCO ) interpretation needs the comparison of measured values to reference values. In 2017, the Global Lung Function Initiative published new reference values (GLI-2017) for D LCO , alveolar volume ( V A ) and transfer coefficient of the lung for carbon monoxide ( K CO ). We aimed to assess the applicability of GLI-2017 reference values for D LCO on a large population by comparing them to the European Community of Steel and Coal equations of 1993 (ECSC-93) widely used. Methods In this retrospective study, spirometric indices, total lung capacity, D LCO , V A and K CO were measured in adults classified in 5 groups (controls, asthma, chronic bronchitis, cystic fibrosis, and interstitial lung diseases (ILD)). Statistical analysis comparing the 2 equations sets were stratified by sex. Results 4180 tests were included. GLI-2017 z-scores of the 3 D LCO indices of the controls (n = 150) are nearer to 0 (expected value in a normal population) than ECSC-93 z-scores. All groups combined, in both genders, D LCO GLI-2017 z-scores and %predicted are significantly higher than ECSC z-scores and %predicted. In the ILD group, differences between the 2 equation sets depend on the D LCO impairment severity: GLI-2017 z-scores are higher than ECSC z-scores in patients with no or “mild” decrease in D LCO , but are lower in “moderate” or “severe” decrease. Conclusion GLI-2017 reference values for D LCO are more suitable to our population and influence the diagnostic criteria and severity definition of several lung diseases.