Chest
Original ResearchDiscriminating Measures and Normal Values for Expiratory Obstruction
Section snippets
Subjects
Data from NHANES III24 were extracted for men and women ≥ 20 years of age for the following ethnic-racial groups: white (white); African-American (black); and Mexican-American (Latin or Latina). These data, from unidentified subjects, had been ethically obtained with Institutional Review Board approval. The term never-smokers included individuals those who had not smoked pipes, cigars, or > 100 cigarettes in a lifetime, and excluded those with known respiratory, skeletal, or neurologic
Results
Several key spirometric values, with respect to ethnicity, gender, age, and height, are provided for the NHANES III never-smokers and current smokers in Table 1. The number of never-smokers (5,938) differs from that of Hankinson et al25 because of differences in age ranges and screening procedures. Table 2 gives the factors needed to derive the linear regression equations for FEV1/FVC and FEV3/FVC for never-smokers (eg, FEV1/FVC or FEV3/FVC = mean constant − age constant × age). The mean
Discussion
This study introduces the concept of the 1 − FEV3/FVC fraction and gives data confirming the utility of the FEV3/FVC ratio in assessing expiratory airway obstruction We took advantage of the NHANES III-verified spirometric and demographic data that were available from a large and diverse US population, and expand on the prior excellent analyses of Hankinson et al25 by adding normal reference values for FEV3/FVC in white, black, and Latin men and women, 20 to 80 years of age (Table 2). We
ACKNOWLEDGMENT
We thank the planners, surveyors, technicians, and subjects who participated in the NHANES III, and the manuscript reviewers for their suggestions.
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2023, The Lancet Global HealthCitation Excerpt :Normal reference ranges for FEF25–75 are affected by variability in both expiratory flows and FVC, which leads to large reference intervals around predicted values.10 Due to this variability, FEF25–75 less than the LLN has been shown at extremes of age to incorrectly classify the presence of airflow obstruction.11 FEV3/FVC ratio does not have the same limitations as FEF25–75, as it accounts for variation in the FVC and therefore has a more acceptable between-person coefficient of variation.
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Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).
This research was supported by the Los Angeles Biomedical Institute at Harbor-UCLA Medical Center.