Within the framework of the European Union Concerted Action on Chronic Obstructive Pulmonary Disease, the data of two epldemiological studies, carried out in the Italian area of Po River Delta and in the Swedish province of Norbotten, were analysed to compare forced expirograms in asymptomatic subjects and to assess the relationship of lung function and risk factors for COPD. In the first step, with the assumption that per cent predicted (% pred) spirometric indexes in asymptomatic subjects should be around 100%, 1,541 Italian and 290 Swedish subjects were compared. A 21703A Hewlett Packard computerized pneumotacograph and prediction equations derived within the sample were used in Italy, while a Minjhardt Vicatest dry spirometer and prediction equations derived from a sample living in South Sweden were used in Sweden. Per cent predicted forced expiratory volume in one second (FEV1) values were four to six points below 100% in Sweden, and only one to three points below 100% in Italy. When considering maximal expiratory flow at 50% (MEF50%) of forced vital capacity in females, there were larger and statistically significant differences between the two populations, with the Swedish values below 90 %. In the second step, multiple logistic regression models were run separately with sex, age, ever-smoking, familial history of asthma, emphysema, and chronic bronchitis as independent variables, and with several categories of lung-function abnormalities, i.e. FEV1/vital capacity (VC)% <70 and different levels of FEV1 (<100, <80, <60%) or MEF50% reduction (<80, <55%), as dependent variables. Apart from age (Swedish subjects were (n=1,384) older than Italian subjects (n=1,981)), there were no important differences between the two samples for the frequency distribution of risk factors. Further, for all the levels of % pred FEV1 and % pred MEF50%, higher proportions of abnormal subjects were found in Sweden. Patterns of association of lung function abnormalities with risk factors were slightly different, with more associations being statistically significant for Sweden. However, the significant risk factors for acquiring a more severe form of airway obstruction were the same in Sweden and Italy, i.e. ageing, ever-smoking, and familial history of chronic bronchitis. In conclusion, differences in lung function among asymptomatic subjects indicate the need to derive reference equations from the population living in the same geographical area of the pulmonary laboratory. Moreover, the different patterns of association of risk factors with abnormalities of both forced expiratory volume in one second/vital capacity and forced expiratory volume in one second demonstrate the utility of transnational cooperation at European level, since it allows new information to be derived from previously performed epidemiological surveys at a low cost.
Comparison of lung function in the Italian and Swedish population samples
Pistelli F.;Carrozzi L.;Giuntini C.
2001-01-01
Abstract
Within the framework of the European Union Concerted Action on Chronic Obstructive Pulmonary Disease, the data of two epldemiological studies, carried out in the Italian area of Po River Delta and in the Swedish province of Norbotten, were analysed to compare forced expirograms in asymptomatic subjects and to assess the relationship of lung function and risk factors for COPD. In the first step, with the assumption that per cent predicted (% pred) spirometric indexes in asymptomatic subjects should be around 100%, 1,541 Italian and 290 Swedish subjects were compared. A 21703A Hewlett Packard computerized pneumotacograph and prediction equations derived within the sample were used in Italy, while a Minjhardt Vicatest dry spirometer and prediction equations derived from a sample living in South Sweden were used in Sweden. Per cent predicted forced expiratory volume in one second (FEV1) values were four to six points below 100% in Sweden, and only one to three points below 100% in Italy. When considering maximal expiratory flow at 50% (MEF50%) of forced vital capacity in females, there were larger and statistically significant differences between the two populations, with the Swedish values below 90 %. In the second step, multiple logistic regression models were run separately with sex, age, ever-smoking, familial history of asthma, emphysema, and chronic bronchitis as independent variables, and with several categories of lung-function abnormalities, i.e. FEV1/vital capacity (VC)% <70 and different levels of FEV1 (<100, <80, <60%) or MEF50% reduction (<80, <55%), as dependent variables. Apart from age (Swedish subjects were (n=1,384) older than Italian subjects (n=1,981)), there were no important differences between the two samples for the frequency distribution of risk factors. Further, for all the levels of % pred FEV1 and % pred MEF50%, higher proportions of abnormal subjects were found in Sweden. Patterns of association of lung function abnormalities with risk factors were slightly different, with more associations being statistically significant for Sweden. However, the significant risk factors for acquiring a more severe form of airway obstruction were the same in Sweden and Italy, i.e. ageing, ever-smoking, and familial history of chronic bronchitis. In conclusion, differences in lung function among asymptomatic subjects indicate the need to derive reference equations from the population living in the same geographical area of the pulmonary laboratory. Moreover, the different patterns of association of risk factors with abnormalities of both forced expiratory volume in one second/vital capacity and forced expiratory volume in one second demonstrate the utility of transnational cooperation at European level, since it allows new information to be derived from previously performed epidemiological surveys at a low cost.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
