Comparison of Race-Neutral versus Race-Specific Spirometry Equations for Evaluation of Child Asthma

作者：Amy L. Non, Xiuhong Li, Miranda R. Jones, Emily Oken, Tina V. Hartert, Nathan Schoettler, Diane R. Gold, Sima Ramratnam, Eric Schauberger, Kelan G. Tantisira, Leonard B. Bacharier, Douglas Conrad, Kecia N. Carroll, Flory L. Nkoy, Heike Luttmann‐Gibson, Frank D. Gilliland, Carrie V. Breton, Meyer Kattan, Robert F. Lemanske, Augusto A. Litonjua, Cindy T. McEvoy, Katherine Rivera‐Spoljaric, Christian Rosas‐Salazar, Christine L.M. Joseph, Meredith Palmore, Patrick Ryan, Alexandra R. Sitarik, Anne Marie Singh, Rachel L. Miller, Edward M. Zoratti, Dennis R. Ownby, Carlos A. Camargo, Judy L. Aschner, Annemarie Stroustrup, Shohreh F. Farzan, Margaret R. Karagas, Daniel J. Jackson, James E. Gern · 发表于：American Journal of Respiratory and Critical Care Medicine · 年份：2024 · DOI：10.1164/rccm.202407-1288oc · 被引用次数：7 · 研究领域：Asthma and respiratory diseases、Chronic Obstructive Pulmonary Disease (COPD) Research

Abstract Rationale Race-based estimates of pulmonary function in children could influence the evaluation of asthma in children from racial and ethnic minoritized backgrounds. Objectives To determine if race-neutral (Global Lung Function Initiative [GLI]-Global) versus race-specific (GLI–Race-Specific) reference equations differentially impact spirometry evaluation of childhood asthma. Methods The analysis included 8,719 children aged 5 to <12 years from 27 cohorts across the United States grouped by parent-reported race and ethnicity. We analyzed how the equations affected FEV1, FVC, and FEV1/FVC z-scores. We used multivariable logistic models to evaluate associations between z-scores calculated with different equations and asthma diagnosis, emergency department visits, and hospitalization. Measurements and Main Results For Black children, the GLI-Global versus GLI–Race-Specific equations estimated significantly lower z-scores for FEV1 and FVC but similar values for FEV1/FVC, thus increasing the proportion of children classified with low FEV1 by 14%. Although both equations yielded strong inverse relationships between FEV1 and FEV1/FVC z-scores and asthma outcomes, these relationships varied across racial and ethnic groups (P < 0.05). For any given FEV1 or FEV1/FVC z-score, asthma diagnosis and emergency department visits were higher among Black and Hispanic than among White children (P < 0.05). For FEV1, GLI-Global equations estimated asthma outcomes tha...