Abstract
The single-breath diffusing capacity of the lung for carbon monoxide (DLCO) interpretation needs the comparison of measured values to reference values. In 2017, the Global Lung Function Initiative published new reference values (GLI-2017) for DLCO, alveolar volume (VA) and transfer coefficient of the lung for carbon monoxide (KCO). We aimed to assess the applicability of GLI-2017 reference values for DLCO on a large population by comparing them to the European Community of Steel and Coal equations of 1993 (ECSC-93) widely used. In this retrospective study, spirometric indices, total lung capacity, DLCO, VA and KCO were measured in adults classified in 5 groups (controls, asthma, chronic bronchitis, cystic fibrosis, and interstitial lung diseases (ILD)). Statistical analysis comparing the 2 equations sets were stratified by sex. 4180 tests were included. GLI-2017 z-scores of the 3 DLCO indices of the controls (n = 150) are nearer to 0 (expected value in a normal population) than ECSC-93 z-scores. All groups combined, in both genders, DLCO GLI-2017 z-scores and %predicted are significantly higher than ECSC z-scores and %predicted. In the ILD group, differences between the 2 equation sets depend on the DLCO impairment severity: GLI-2017 z-scores are higher than ECSC z-scores in patients with no or "mild" decrease in DLCO, but are lower in "moderate" or "severe" decrease. GLI-2017 reference values for DLCO are more suitable to our population and influence the diagnostic criteria and severity definition of several lung diseases.
Highlights
The single-breath diffusing capacity of the lung for carbon monoxide (DLCO) is a simple noninvasive way to evaluate the alveolar-capillary gas exchanges [1]
In the ILD group, differences between the 2 equation sets depend on the DLCO impairment severity: Global Lung Function Initiative (GLI)-2017 z-scores are higher than European Community of Steel and Coal (ECSC) z
GLI-2017 reference values for DLCO applied to a large population
Summary
The single-breath diffusing capacity of the lung for carbon monoxide (DLCO) is a simple noninvasive way to evaluate the alveolar-capillary gas exchanges [1]. In Europe, the European Community of Steel and Coal (ECSC) reference values for DLCO parameters, published in 1983 [2] (ECSC-83) and updated in 1993 [3,4] (ECSC-93), are the most commonly used. They are linear regression equations based on regression equations collation published before 1983. The single-breath diffusing capacity of the lung for carbon monoxide (DLCO) interpretation needs the comparison of measured values to reference values. We aimed to assess the applicability of GLI-2017 reference values for DLCO on a large population by comparing them to the European Community of Steel and Coal equations of 1993 (ECSC-93) widely used
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