0
Clinical Investigations: TECHNIQUES |

Spirometry Reference Values for American Indian Adults*: Results From the Strong Heart Study

M. Susan Marion, PhD; Gary R. Leonardson, PhD; Everett R. Rhoades, MD; Thomas K. Welty, MD, MPH; Paul L. Enright, MD
Author and Funding Information

*From the Aberdeen Area Tribal Chairmen’s Health Board (Drs. Marion, Leonardson, and Welty), Rapid City, SD; the College of Medicine, University of Oklahoma Health Sciences Center (Dr. Rhoades), Oklahoma City, OK; and the University of Arizona Health Sciences Center (Dr. Enright), Tucson, AZ. Supported by National Heart, Lung, and Blood Institute contracts U01-HL41642, HL41652, and HL41654.

Correspondence to: Paul Enright, MD, University of Arizona, HSC 2342, 1501 North Campbell Ave, Tucson, AZ 85724; e-mail: lungguy@aol.com



Chest. 2001;120(2):489-495. doi:10.1378/chest.120.2.489
Text Size: A A A
Published online

Study objective: To derive spirometry normative values from a large population of American Indian adults and compare them to reference values for white adults.

Design: Pulmonary function was assessed using spirometry in participants of the Strong Heart Study, a multicenter, community-based, prospective study of cardiovascular risk factors and disease in American Indians, utilizing American Thoracic Society guidelines and a vigorous quality assurance program.

Setting: Central Arizona, southwestern Oklahoma, central South Dakota, and northeastern North Dakota.

Participants: Acceptable spirometry results were obtained from 1,619 women and 1,005 men aged 45 to 74 years.

Results: Internal reference values and normal ranges for FEV1, FVC, and the FEV1/FVC ratio were derived from a healthy subgroup of 253 women and 190 men, identified by excluding participants with factors associated with a lower FEV1. Ten percent of the entire cohort (269 of 2,624 subjects) had airways obstruction, as defined by an FEV1/FVC below the lower limit of the normal (LLN) using the internal reference equations. After allowing for measurement“ noise,” 31 participants were below the LLN using reference equations for white adults from the large National Health and Nutrition Examination Study (NHANES) III study but were normal using the internal reference equations (1.3% false-positive), while 27 participants were classified as normal using NHANES III equations but had airways obstruction using the internal reference equations (1.2% false-negative). Similarly low misclassification rates were seen for a low FVC (prevalence, 17.6%).

Conclusion: For clinical purposes, NHANES III spirometry reference equations for white adults may be used when testing American Indian women and men aged 45 to 74 years.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543