Applicability of the Global Lung Initiative 2012 Reference Values for Spirometry for Longitudinal Data of Elderly Women

PLoS One. 2016 Jun 16;11(6):e0157569. doi: 10.1371/journal.pone.0157569. eCollection 2016.


Background and objectives: Lung function depends nonlinearly on age and height, so that the use of age and height specific reference values is required. The widely used age and height specific GLI (Global Lung Initiative) z-scores derived from cross-sectional data, however, have not been proven for validity in an elderly population or for longitudinal data. Therefore, we aimed to test their validity in a population of elderly women followed prospectively for more than 20 years.

Methods: We used spirometric data (forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) and FEV1/FVC) from the SALIA cohort of German women (baseline: 1985-1994 (aged 55 years), follow-up: 2008/2009 and 2012/2013). We calculated GLI-z-scores for baseline and follow-up examination separately (cross-sectional evaluation) and individual differences in z-scores between baseline and follow-up (longitudinal evaluation) for healthy never-smoking women.

Results: GLI reference values for FEV1, FVC and FEV1/FVC were cross-sectionally and longitudinally equivalent with our SALIA data. The mean change in z-scores between baseline and follow-up was 0.33 for FEV1, 0.38 for FVC and -0.10 for FEV1/FVC.

Conclusions: In conclusion, GLI z-scores fit cross-sectionally and longitudinally with FEV1, FVC and FEV1/FVC measured in women from Germany which indicates that they can be used in longitudinal association analyses.

MeSH terms

  • Aged
  • Cross-Sectional Studies
  • Female
  • Forced Expiratory Volume / physiology*
  • Germany
  • Humans
  • Longitudinal Studies
  • Lung / physiology*
  • Middle Aged
  • Reference Values
  • Social Class
  • Spirometry
  • Vital Capacity / physiology*

Grant support

This work was supported by the Deutsche Forschungsgemeinschaft (DFG; HE-4510/2-1, KR 1938/3-1, LU 691/4-1), by the Ministry of the Environment of the state North Rhine-Westphalia (Düsseldorf, Germany), by the Federal Ministry of the Environment (Berlin, Germany); DGUV (German statutory accident assurance) VT 266.1, by the European Community’s Seventh Framework Program (FP7/2007-2011) under grant agreement number 211250, by the German Federal Ministry of Education and Research (BMBF) and by the Research Commission of the Medical Faculty of the Heinrich-Heine University of Düsseldorf (12/2011). The publication of this article was funded by the Open Access fund of the Leibniz Association.