Statement on New Reference Values for Spirometry

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  • Kubota Masaru
    Respiratory Medicine, School of Medicine, Kitasato University

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  • 日本総合健診医学会　第45回大会・シンポジウム6　COPDの早期発見を目指して<br>新たなスパイロメトリー基準値に関するステートメント

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Abstract

 Pulmonary function tests are essential for the diagnosis and management of chronic obstructive pulmonary disease (COPD). It is important to detect the presence of airflow limitation by spirometry at medical examination for screening of COPD. Because spirometry is affected by gender, age, height, and ethnicity, measurement results must be compared to reference values adjusted for these factors. Japan Respiratory Society (JRS) published new spirometric reference values and lower limit of normal (LLN) for Japanese adults in 2014. The new reference values for FEV1/FVC are smaller than previous values in both genders. The LLN of the FEV1/FVC for females is larger than previous values. The presence of a post-bronchodilator FEV1/FVC < 0.7 confirms the presence of persistent airflow limitation and the diagnosis of COPD. Fixed lower limit of 0.7 crossed with the LLN at about 60 years in males and at about 70 years in females. The use of a fixed ratio of FEV1/FVC<0.7 to define COPD leads to an underdiagnosis apart from the elderly.

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