Reference equations for spirometric indices from a sample of the general adult population in Nigeria

Abstract

Background: The increasing importance of pulmonary function testing in diagnosing and managing lung diseases and assessing improvement has necessitated the need for locally derived reference equations from a sample of the general Nigerian population. Methods: It was a cross sectional study in which we used linear regression models to obtain equations for reference values and lower limits of normal for spirometric indices in adult Nigerians from a sample of the general population aged 18–65 years (males) and 18–63 years (females). Results: Seven hundred and twenty participants made up of 358 males and 362 females who satisfactorily completed the spirometric measurements using the ATS/ERS reproducibility and acceptability criteria were included in the analysis. The most important predictive variables were height and age. The values of the spirometic indices increase with increasing stature but decrease with increasing age in both sexes. The sex difference in all the indices is also apparent as all the indices, except FEV1/FVC, are higher in men than in women. Our values are higher than values obtained from previous studies in Nigeria (except FEV1/FVC) but the differences were not statistically significant. This suggests that although the values are increasing, the increase is yet to be significantly different from values obtained using the past equations. The implication of this is that there is need for periodic study to derive new equations so as to recognise when there is significant difference. There was no significant difference between values from our equations and those obtained from study among Ethiopians. Compared to report from Iran, our FVC and FEV1values (in males and females) as well as PEFR (in females) are significantly lower. Our values are also lower than values from Poland. We also observed disparities between our values and those of Afro Americans from the GLI study. Conclusions: Our findings show that it is important to always interpret ventilatory function tests in any individual by comparing it with reference values obtained from a well-defined population of healthy subjects of the same ethnic origin in similar geographic location.