title: Age Dependency of GLI Reference Values Compared with Paediatric Lung Function Data in Two German Studies (GINIplus and LUNOKID).
abstract: A hallmark of the newly published GLI (Global Lungs Initiative) spirometric reference values is their "all-age" (3-95yr) predictive power, accomplished by incorporating non-linear age dependencies into modelling parameters. This modelling strategy is especially promising for the age range of puberty; however, the performance of GLI-values for adolescents is currently unknown. We calculated GLI-based z-scores for children/adolescents without apparent respiratory diseases from two different German studies, LUNOKID (N = 1943, 4-19 years) and GINIplus (N = 1042, 15 years) and determined the goodness of fit for specific age groups. We defined fit sufficient if the absolute mean of z-scores was <0.5. For children (<10yr) the mean GLI-based z-scores for FEV1 and FVC reached a good fit with mean z-scores for FEV1 between -0.11 and 0.01 and mean z-scores for FVC between 0.01 and 0.16, but larger deviations were observed in adolescents, especially boys (mean z-score -0.58 for FEV1 and -0.57 for FVC in GINIplus). The fit for FEV1/FVC was sufficient. GLI reference values provided reasonable estimates for the individuals enrolled in our studies, which span the age range of lung growth and development. However, we found that GLI-predictions overestimated lung volumes, especially those for German adolescent boys, which may, left unrecognised, lead to erroneous diagnosis of lung disease. Caution should be taken when applying these reference values to epidemiologic studies.
authors.affiliation: IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany.
authors.forename: Anke
authors.initials: A
authors.lastname: Hüls
authors.affiliation: IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany.
authors.forename: Ursula
authors.initials: U
authors.lastname: Krämer
authors.affiliation: Marien Hospital Wesel, Children's Hospital and Research Institute, Wesel, Germany.
authors.forename: Monika
authors.initials: M
authors.lastname: Gappa
authors.affiliation: Medical School of Hanover, Department of Anaesthesiology and Intensive Care Medicine, Hanover, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Müller-Brandes
authors.affiliation: IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany.
authors.forename: Tamara
authors.initials: T
authors.lastname: Schikowski
authors.affiliation: Marien Hospital Wesel, Children's Hospital and Research Institute, Wesel, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: von Berg
authors.affiliation: IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany.|Medical Faculty, Heinrich-Heine University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Barbara
authors.initials: B
authors.lastname: Hoffmann
authors.affiliation: Heinrich-Heine University, University Children's Hospital, Düsseldorf, Germany.
authors.forename: Antje
authors.initials: A
authors.lastname: Schuster
authors.affiliation: Heinrich-Heine University, University Children's Hospital, Düsseldorf, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Wisbauer
authors.affiliation: Institute of Epidemiology I, Helmholtz Zentrum München - erman Research Center for Environmental Health, Munich, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Flexeder
authors.affiliation: Institute of Epidemiology I, Helmholtz Zentrum München - erman Research Center for Environmental Health, Munich, Germany.|Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Heinrich
authors.affiliation: Institute of Epidemiology I, Helmholtz Zentrum München - erman Research Center for Environmental Health, Munich, Germany.|Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Schulz
authors.affiliation: Marien Hospital Wesel, Children's Hospital and Research Institute, Wesel, Germany.
authors.forename: Dietrich
authors.initials: D
authors.lastname: Berdel
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008168:Lung / Q000503:physiopathology*; D008171:Lung Diseases / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D011627:Puberty / Q000502:physiology; D012016:Reference Values; D013147:Spirometry / Q000379:methods*; D044465:White People; D055815:Young Adult