What question did this study set out to answer?

This research aims to assess the impact of transitioning from race-specific to race-neutral equations on lung function measurements in a predominantly Caucasian population.

March 1, 2026Open Access

Impact of transitioning from Race-specific to Race-neutral GLI equation on lung function in a predominantly Caucasian population

Puntos clave

This research aims to assess the impact of transitioning from race-specific to race-neutral equations on lung function measurements in a predominantly Caucasian population.
Conducted a sub-study of CoLaus|PsyCoLaus in Lausanne, Switzerland.
Performed spirometry on 3330 participants at baseline and 2005 at follow-up over several years.
Compared %predicted values of FEV1 and FVC using GLI-2022 versus GLI-2012 reference equations.
Analyzed data with paired t-tests and linear regression for age, sex, and social class effects.
The %predicted values for FEV1 increased by 4.2% at baseline and 4.6% at follow-up using GLI-2022, both statistically significant (p<0.0001).
The %predicted values for FVC increased by 4.9% at baseline and 5.6% at follow-up (p<0.0001).
Younger individuals, males, and those with only compulsory education showed the greatest increases in lung function metrics.
The prevalence of low FEV1 and FVC decreased, while obstructive ventilatory impairment prevalence increased.

Resumen

Introduction Diagnosis and treatment decisions for many respiratory diseases are based on spirometric values. We compared the impact of changing the reference equations from GLI-2012 (race-specific) to GLI-2022 (race-neutral) in a predominantly Caucasian urban population. Methods PneumoLaus is a sub-study of CoLaus|PsyCoLaus, an ongoing prospective observational study conducted in Lausanne, Switzerland. Participants performed spirometry at baseline (2014-2017) and at follow-up (2018-2021, FU). We analysed changes of %predicted values (PV) for Forced Expiratory Volume in One second (FEV1) and Forced Vital Capacity (FVC) by comparing the GLI-2022 reference equation to GLI-2012. Sub-group analyses were performed for social class, sex and age using paired t-tests corrected by Holm-Bonferroni. We analysed the association of age, sex and social class on the differences using linear regression. Results A total of 3330 participants were included at baseline and 2005 at FU, >97% Caucasian. Employing GLI-2022 equations, the %PV increased significantly for both FEV1 (4.2%PV and +0.31 Z-score baseline, 4.6%PV and +0.28 Z-score FU, both p<0.0001) and FVC (4.9%PV and +0.34 Z-score baseline, 5.6%PV and + 0.29 Z-score FU, both p<0.0001). Younger individuals, males, and participants with only compulsory school education experienced the greatest increase. The prevalence of low FEV₁ and low FVC decreased using GLI-2022 references, while the prevalence of obstructive ventilatory impairment increased at baseline and FU (all p<0.05). Discussion In this predominantly Caucasian urban population-based cohort, applying GLI-2022 equations led to a general FEV1 and FVC %PV increase, particularly among younger individuals, males, and participants with only compulsory school education. Applying GLI-2022 equations also led to a general FEV1 and FVC z-score increase. These findings changes may carry relevant implications for clinical care and social policy decisions.

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