Chest
Original ResearchUpdated Spirometric Reference Values for Adult Chinese in Hong Kong and Implications on Clinical Utilization
Section snippets
Materials and Methods
The study was carried out between January 2001 and March 2003 on subjects residing in the Hong Kong Special Administrative Region, China, where 98% of the population are ethnic Chinese. Ethics committee approval was obtained from The University of Hong Kong (HKU) and each of the eight hospitals where the study was performed. Written informed consent was obtained from each subject before lung function testing.
Results
The age and gender distribution of the participants are shown in Figure 1. Table 1 shows the prediction equations of spirometry chosen for our population as a result of the above analysis. In developing the regression model, age and height were found to be significant independent variables for all pulmonary function parameters. Adding weight and body mass index did not improve the R2. Transformation of spirometric parameters, already mentioned in the “Methods” section, did not improve the R2
Discussion
This is a study of reference values of spirometric lung function in a random population of Chinese adults in Hong Kong. All relevant data were obtained by trained technicians from healthy nonsmokers using standardized equipment, techniques, acceptability, and reproducibility. The predicted spirometric values derived from this study showed varying degrees of difference when compared with those derived from studies on white subjects as well as other studies on Chinese.
Differences in predicted
Conclusions
Our findings reinforce the importance of using lung function values derived from nonsmoking populations matched for ethnicity, and such data may need to be examined periodically for secular trends. The use of an adjustment factor applied to prediction equations derived from external populations for race correction may lead to overestimation or underestimation of predicted values. When it is not feasible to obtain reference lung function values from the same community, it is important to adopt
ACKNOWLEDGMENT
The authors thank Ms. Agnes Lai for coordination of the study and data management; Mr. K. M. Lo for providing expert technical advice on standardization of lung function testing procedures; Ms. Anne Dybuncio (University of British Columbia) and Dr. Daniel Fong (The University of Hong Kong) for statistical analysis; Dr. Michael Schalzer (University of British Columbia) for statistical advice; and nurses and technicians of the participating lung function laboratories for their technical support.
References (38)
- et al.
Rise and fall of the FEV1
Chest
(2000) - et al.
Patterns of lung function in asymptomatic nonsmoking men and women in the People's Republic of China
Ann Epidemiol
(2002) - et al.
Ethnic differences in normal spirometric lung function of Malaysian children
Respir Med
(1994) - et al.
Allergic sensitization, symptoms, and lung function among bakery workers as compared with a nonexposed work population
J Occup Environ Med
(2003) - et al.
Association between chronic obstructive pulmonary disease and employment by industry and occupation in the US population: a study of data from the Third National Health and Nutrition Examination Survey
Am J Epidemiol
(2002) - et al.
Early life factors contribute to the decrease in lung function between ages 18 and 40: the Coronary Artery Risk Development in Young Adults study
Am J Respir Crit Care Med
(2002) - et al.
Outcome in adulthood of asymptomatic airway hyperresponsiveness in childhood: a longitudinal population study
Pediatr Pulmonol
(2002) - et al.
Smoking cessation and lung function in mild-to-moderate chronic obstructive pulmonary disease: the Lung Health Study
Am J Respir Crit Care Med
(2000)
Exposure-response relationship between paternal smoking and children's pulmonary function
Am J Respir Crit Care Med
Ethnic differences in pulmonary function in healthy nonsmoking Asian-Americans and European-Americans
Am J Respir Crit Care Med
Lung function reference values in Chinese children and adolescents in Hong Kong: I. Spirometric values and comparison with other populations
Am J Respir Crit Care Med
Lung function reference values in Chinese children and adolescents in Hong Kong: II. Prediction equations for plethysmographic lung volumes
Am J Respir Crit Care Med
Spirometric reference values in a large Middle Eastern population
Eur Respir J
Prospective study of diet and decline in lung function in a general population
Am J Respir Crit Care Med
Recommended respiratory disease questionnaire for use with adults and children in epidemiology research
Am Rev Respir Dis
Secular changes in standing height, sitting height and sexual maturation of Chinese: the Hong Kong Growth Study, 1993
Ann Hum Biol
American Thoracic Society
Am J Respir Crit Care Med
Cited by (0)
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).
This study is funded by a Research Grant from the Pneumoconiosis Compensation Fund Board, Hong Kong.