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New Danish reference values for spirometry

Authors

  • Anders Løkke,

    1. Department of Respiratory Medicine, Aarhus County Hospital, Aarhus, Denmark
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  • Jacob Louis Marott,

    1. The Copenhagen City Heart Study, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
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  • Jann Mortensen,

    1. Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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  • Børge Grønne Nordestgaard,

    1. The Copenhagen City Heart Study, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
    2. Department of Clinical Biochemistry, Herlev Hospital, University of Copenhagen, Herlev, Denmark
    3. The Copenhagen General Population Study, Herlev Hospital, Herlev, Denmark
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  • Morten Dahl,

    1. Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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  • Peter Lange

    Corresponding author
    1. The Copenhagen City Heart Study, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
    2. Department of Social Medicine, Institute of Public Health, University of Copenhagen, Denmark
    3. Respiratory Section, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
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  • Authorship and contributorship

  • Study concept and design: AL, PL, JLM, JM MD, BGN, Acquisition of data: PL, BGN, MD, Analysis and interpretation of data: AL, PL, JLM, JM, Drafting of the manuscript: AL, PL, JLM, Critical revision of the manuscript for important intellectual content: All authors, Statistical analysis: JLM, AL, PL, Obtained funding: BGN, PL, Administrative, technical and material support: BGN, PL, Study supervision: PL, BGN.

  • Ethics

  • The study has been approved by institutional review boards and Danish Ethical Committee.

  • Conflict of interest

  • The authors have stated explicitly that there are no conflicts of interest in connection with this article.

Peter Lange, Professor, Department of Public Health, Section of Social Medicine, Copenhagen University, P.O.B. 2099, Øster Farimagsgade 5, DK-1014 Copenhagen K, Denmark. Tel: +45 35 32 79 65, Fax: +45 35 35 11 81, Mob: +45 26 87 90 20, email: plange@dadlnet.dk

Abstract

Introduction:  International recommendations state that reference values for lung function should derive from cross-sectional studies of healthy nonsmokers and be renewed from time to time because of cohort effect and newer, more accurate, technical equipment. In 1986, the Danish Lung Society published reference values for spirometry based on 570 individuals aged 30–70 years.

Objectives:  To produce new reference values for lung function and to extend the existing values by including individuals between 20 and 30 years of age and older than 70 years of age.

Methods:  Two similar but independent studies was used: The 2001–2003 examination of the Copenhagen City Heart Study and the 2003–2010 examination of the Copenhagen General Population Study. Of a total of 69 822 individuals, we included 11 288 healthy never-smoking white individuals to produce the reference values: 6307 women and 4981 men, 20 years of age or older with adequate lung function.

Results:  We used sex-stratified multiple linear regression analysis to find prediction formulas for forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC adjusted for age and height. The cutoff value of normal lung function was defined as the fifth percentile (also named the 5% quantile) according to gender, age and height. The robustness of the data was tested and validated in several ways.

Conclusion:  Compared with the 1986 data, our 2001–2010 material contributes with a substantial number of individuals in the more extreme groups of age and height, and in general, our dataset shows that in most subgroups, the lung function level has improved during the last two decades.

Please cite this paper as: Løkke A, Marott JL, Mortensen J, Nordestgaard BG, Dahl M and Lange P. New Danish reference values for spirometry. Clin Respir J 2013; 7: 153–167.

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