The need for race-specific reference equations for pulmonary diffusing capacity for nitric oxide

BMC Pulmonary Medicine

Douglas Shawn Gardenhire¹  Shi Huh Samuel Shan¹  Ahmad Saleh Almamary²  Mobarak Khalid Alqahtani³  Gerald Stanley Zavorsky⁴ 

[1] Department of Respiratory Therapy, Georgia State University, Atlanta, GA, USA;Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, UK;Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK;Pulmonary Services Department, University of California, Davis, Medical Center, 2315 Stockton Boulevard, Room 5703, 95817, Sacramento, CA, USA;

关键词: Ethnicity;    Prediction equations;    Lung function;    False positives;    Carbon monoxide;   

DOI  :  10.1186/s12890-021-01591-7

来源: Springer

【 摘 要 】

BackgroundFew reference equations exist for healthy adults of various races for pulmonary diffusing capacity for nitric oxide (DLNO). The purpose of this study was to collect pilot data to demonstrate that race-specific reference equations are needed for DLNO.MethodsAfrican Americans (blacks) were chosen as the comparative racial group. In 2016, a total of 59 healthy black subjects (27 males and 32 females) were recruited to perform a full battery of pulmonary function tests. In the development of DLNO reference equations, a white reference sample (randomly drawn from a population) matched to the black sample for sex, age, and height was used. Multiple linear regression equations for DLNO, alveolar volume (VA), and pulmonary diffusing capacity for carbon monoxide (DLCO) using a 5–6 s breath-hold were developed.ResultsOur models demonstrated that sex, age2, race, and height explained 71% of the variance in DLNO and DLCO, with race accounting for approximately 5–10% of the total variance. After normalizing for sex, age2, and height, blacks had a 12.4 and 3.9 mL/min/mmHg lower DLNO and DLCO, respectively, compared to whites. The lower diffusing capacity values in blacks are due, in part, to their 0.6 L lower VA (controlling for sex and height).ConclusionThe results of this pilot data reveal small but important and statistically significant racial differences in DLNO and DLCO in adults. Future reference equations should account for racial differences. If these differences are not accounted for, then the risk of falsely diagnosing lung disease increase in blacks when using reference equations for whites.

【 授权许可】

CC BY