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Reference equations of lung function in healthy Asian children aged 5 to 18 years

This paper is available in a repository.
This paper is available in a repository.

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Abstract

Background and aims: There is an unmet need for updated reference values for lung function in Asian Children. The aim of this study was to establish updated spirometric reference values and prediction equations for Asian children in Taiwanwith the use of GAMLSS method and adjustment for the Global Lungs Initiative (GLI) 2012 spirometric prediction equations. Methods: 757 healthy Asian children aged 5 to 18 years living in Taiwan were assessed using spirometry. Eight lung function parameters were analyzed: forced vital capacity (FVC), forced expiratory volume in 1 second (FEV 1 ), FEV 1 /FVC ratio, peak expiratory flow (PEF), forced expiratory flow at 25% (FEF 25 ), FEF 50 , FEF 75 , and FEF 25 – 75 . Prediction equations were derived using both linear regression models and generalized additive models in the R package GAMLSS considering location, scale and shape under various model settings. The modeling results were compared to the GLI 2012 equations and the best fitting models were selected based on the Bayesian Information Criterion (BIC). Results: Prediction equations for lung function parameter in study subjects were provided. The prediction equations with the use of a novel statistical methodremarkably outperformed those derived from the conventional linear regression models. Linear models with direct combination of predictors without considering data distributions may not be sufficient and effective in generating reference values of all the lung function parameters. Conclusions: With the use of GAMLSS and the guide of the GLI 2012 equations, this study provides updated spirometric reference values and prediction equations for Asian children in Taiwan.