Many black men with “normal” lung function may actually have emphysema

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Black men with emphysema may be misdiagnosed due to racial spirometry adjustments. Credit: ATS

According to a study published at the ATS 2022 international conference, a significant percentage of black men who have normal lung function, after adjusting for spirometry based on race, were diagnosed with emphysema on their computed tomography (CT) scans.

“Black adults in the United States often go unrecognized emphysema of the lungs than white adults. This is partly due to the normalization of lower lung function in colored people through racial interpretations of spirometry, “said study author Gabrielle Liu, MD, researcher in pulmonary and resuscitation, Feinberg Medical School, Northwestern University in Chisinau. This observational sample of middle-aged adults in the United States found that 14.6 percent of black men (vs. 1.7 percent of whites) with spirometry “above normal” based on racial equations were diagnosed with emphysema on CT imaging. lung health based on racial spirometry can significantly underestimate airway impairment in black people. ”

This standard practice interpret the results of spirometry using racial norms, which leads to a decrease in the projected lower limit of the “norm” for FEV1 and FVC for black patients. FEV1 – is the maximum amount of air that a person can forcibly exhale in one second, and FVC – is the forced vital capacity – the maximum amount of exhaled force after a deep breath. There is no practice of racial correction biological basis and is based on a mistaken belief first proposed at the time colonial timesthat black individuals have smaller lungs.

Spirometry is a commonly used lung function test in which a patient exhales forcefully into a mouthpiece connected to a spirometry machine. The device measures how much air a person is able to exhale and inhale, and helps determine if it has lung disease. Emphysema, which involves the gradual destruction of lung tissue, is often associated with COPD and can lead to extremely poor health outcomes.

Dr. Liu and colleagues evaluated the association between self-identified race and visually identified emphysema on CT in participants with normal spirometry who participated in a multicenter study of coronary artery risk in young adults (CARDIA) observed in black and white since 1985. This study examined CT scans of 2,674 participants when they were on average 50 years old, and spirometry results when they were 55 years old.

“We found that significant racial differences in the prevalence of emphysema occur predominantly among those with FEV1 80 to 120 percent of the predicted, “said Dr. Liu.” This suggests that the greatest potential for misclassification using racial equations occurs among black adults who are at risk for the disease and who could potentially benefit from modifying factors. risks “.

The research team also wanted to know whether individual socioeconomic status (SES) and smoking could contribute to more emphysema in black participants, and whether the link between race and emphysema among those with similar lung function would be reduced or eliminated. and SES. They found that there was still a racial disparity in emphysema among those with a similar predicted race-specific FEV1 . However, after adjustments to EPS and smoking, the difference in the prevalence of emphysema between black and white men decreased.

“We believe these findings support a revision of the use of reference spirometry equations for race in favor race-neutral reference equations and support further research into the usefulness and implications of including CT imaging in the assessment of those suspected of impaired airway health and normal spirometry, ”said Dr. Liu.


Removal of “racial correction” in lung function tests highlights health inconsistencies


Additional information:
Abstract: www.abstractsonline.com/pp8/#! … 76 / presentation / 4762

CitationA: Many black men with “normal” lung function may actually have emphysema (2022, May 16), obtained May 16, 2022 from https://medicalxpress.com/news/2022-05-black-men- lung-function-emphysema.html

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