上海地区正常成人第1秒用力吸气容积正常值及预计方程式的探索

目的 探索上海市正常人群第1秒用力吸气容积(forced inspiratory volume in one second,FIV1)的预计值和医学参考值范围.方法 对上海地区521名健康成年人,采用德国耶格公司生产的Master Screen difiusion(SN:694855)型肺功能仪测定FIV1,探索正常人群FIV1的预计值和医学参考值范围,分析正常人群FIV1与年龄、体质量以及身高的相关性.结果 肺功能参数FIV1与身高和年龄呈正相关,但FIV1与身高的关系最为密切,与体质量无关.正常成年男性FIV1预计值的回归方程为FIV1=-5.351+0.061*身高-0.027*年龄(身高、年龄P＜0.001,体质量P＞0.05),医学参考值范围为2.107 5～4.959 1;正常成年女性FIV1预计值的回归方程为FIV1 =-2.457+0.04*身高-0.025*年龄(身高、年龄P＜0.001,体质量P＞0.05),医学参考值范围为1.278 3～3.517 1.结论 FIV1值与身高和年龄有关,建立并推荐上海地区使用本成人FIV1正常预计值.     

上海地区正常成人第1秒用力吸气容积正常值及预计方程式的探索

目的探索上海市正常人群第1秒用力吸气容积（forcedinspiratoryvolumeinonesecond，FIV1）的预计值和医学参考值范围。方法对上海地区521名健康成年人，采用德国耶格公司生产的MasterScreendifiusion（SN：694855）型肺功能仪测定FIV1，探索正常人群FIV1的预计值和医学参考值范围，分析正常人群FIV1与年龄、体质量以及身高的相关性。结果肺功能参数FIV1与身高和年龄呈正相关，但FIV。与身高的关系最为密切，与体质量无关。正常成年男性FIV。预计值的回归方程为FIV1=-．351＋0．061＊身高-0．027＊年龄（身高、年龄P〈0．001，体质量P〉0．05），医学参考值范围为2．1075-4．9591；正常成年女性FIV。预计值的回归方程为FIV1=-2．457＋0．04＊身高-0．025＊年龄（身高、年龄P〈0．001，体质量P〉0．05），医学参考值范围为1．2783～3．5171。结论FIVl值与身高和年龄有关，建立并推荐上海地区使用本成人FIV，正常预计值。     

合肥市学龄期健康儿童肺功能正常值测定及影响因素分析

目的测定学龄期健康儿童肺功能并分析影响因素、评估与现行判断标准间有无差异,为我市儿童肺功能值建立提供依据。方法随机抽取某学校6～12岁280名健康儿童进行肺功能检测,1岁为一个年龄组,共7组,每个年龄组40例,男女各20例,并记录其性别、出生日期、身高、体重,应用德国耶格公司生产的MasterScreen pneumo型肺功能仪进行肺功能测定,取最能反映肺功能的4个参数作为测定指标,即用力肺活量(FVC)、第1秒钟用力呼出气体容量(FEV1)、峰值呼气流速(PEF)、最大呼气中段流速(MMEF 75/25)。每个测试者测3次,取最好的一次结果记录打印。结果单因素相关性分析发现FVC、FEV1、PEF、MMEF 75/25与年龄、身高、体重、BMI相关,经统计学处理均有显著性差异(P 0. 05),且FVC与性别相关,不同性别间有显著性差异(P 0. 05);多元回归分析显示不同性别间FVC、FEV1、PEF、MMEF 75/25均与身高相关,年龄、体重的影响则因指标而异;实测均值与预计均值比较,FVC、PEF、MMEF 75/25经统计学处理有显著性差异(P 0. 05)。结论年龄、性别、身高、体重、BMI是儿童肺功能的影响因素,FVC、PEF、MMEF 75/25的实测均值与预计均值间的差异存在统计学差异。     

肺年龄在评估肺功能损害中的作用探讨

众多的致病因素中 ,香烟烟雾是引起COPD最重要的危险因素。笔者在实践中发现除了应用肺量计测定FEV1来表明吸烟者通气功能的损害———即将受试者FEV1 测定结果与预计参考值比较外 ,还可用“肺年龄”(lungage)来表明吸烟的危害。所谓肺年龄是指与患者肺功能测定结果(FEV1 )相对应的正常受试者的年龄 ,如果一个受试者肺年龄老于实际年龄的程度越严重 ,即其对外界有害因素更易感。可利用线性回归方程推算出每一位患者的肺年龄 ,再将肺年龄与受试者实际年龄相比较 ,用以评价吸烟对肺的损害程度 ,这样对于劝告患者尽早戒烟 ,效果较好 ,现…     

出生体重、孕周对学龄儿童肺功能的影响

目的研究出生体重、孕周与学龄儿童肺功能测定指标之间的关系。方法测定35名6～9岁低出生体重儿的身高、体重、肺功能,调查孕周以及被动吸烟情况,并与年龄、性别配对的正常出生体重儿童进行比较。结果(1)低出生体重组儿童的用力肺活量(FVC)、一秒钟用力呼气容积(FEV     

体液免疫变化对哮喘-慢性阻塞性肺疾病重叠综合征肺功能的影响

目的探讨体液免疫变化对哮喘-慢性阻塞性肺疾病重叠综合征肺功能的影响。方法选择2015年1月至2016年12月本院收治的哮喘-慢性阻塞性肺疾病重叠综合征患者40例为观察组,同时选择同期正常体检者40例为正常组,对所有入组者其体液免疫功能进行检查,同时测定其肺功能,重点了解第一秒用力呼气容积(FEV1%)变化,并计算s Ig A水平与FEV1相关性及Ig M与FEV1相关性。结果观察组Ig M、Ig G、Ig A及s Ig A水平均明显低于正常组(P0.05),观察组FEV1小于正常组(P0.05),FEV1/FVC水平低于正常组(P0.05),哮喘-慢性阻塞性肺疾病重叠综合征机体s Ig A水平及Ig M与FEV1值呈正相关(r=0.8611和0.8421,P=0.0000.05)。结论哮喘-慢性阻塞性肺疾病综合征患者,其机体免疫力降低,肺功能变差,且机体免疫能力与肺功能变化之间存在正相关性。     

吸烟对40岁以上人群的肺功能的影响

目的 观察吸烟对40岁以上人群的肺功能的影响.方法 本研究前瞻性调查了2 682例居民的吸烟状况、规律合并用药情况、性别、年龄、身高、体质量等资料,并进行了肺通气功能检测.结果 随访时间2年.2 290例(85.4%)得到了有效随访,其中1 197例(52.3%)从不吸烟,467例(20.4%)曾经吸烟,626例(27.3%)现吸烟.三组人群的年龄、性别、BMI、肺功能、COPD患者例数及合并用药差异均有统计学意义.随访结果显示,肺功能FEV1、FEV1%pred、FVC、FEV1/FVC均逐年下降.经调整上述差异性变量(年龄、性别、BMI、COPD患者例数、合并用药及基线肺功能),曾吸烟组肺功能FEV1(P=0.030)、FEV1%pred(P=0.011)和FEV1/FVC(P<0.001)较从不吸烟组显著下降.现吸烟组FEV1/FVC较从不吸烟组下降快.结论 从不吸烟居民肺功能下降最慢,提倡不吸烟或尽可能早期戒烟.     

老年CT肺密度测定与肺功能的相关性研究

目的初步探讨正常老年人群平均肺密度的特点及与肺功能的相关性。方法将肺功能正常者40例分为老年组25例(年龄60￣83岁,平均年龄72.5岁),中青年组15例(年龄27￣57岁,平均年龄48.65岁),进行CT平均肺密度及肺功能的测定。采用Siemens16层螺旋CT附带的Pulmo软件分别对全肺、主动脉弓、隆凸、肺静脉层面的平均肺密度进行测定。常规肺功能指标取FEV1的实测值与预测值的比值及FEV1/FVC、DLCO的实测值。并将两者行相关性分析,同时观察本组对象肺HRCT的细微结构的改变。结果测得的老年组全肺及上、中、下肺野的平均肺密度值分别为-732.29±48.35HU、-757.65±42.36HU、-773.78±46.12HU、-724.41±48.76HU。与中青年组比较仅中肺野密度有明显升高,且失去了自上而下的梯度改变,与常规肺功能指标无相关性。在肺HRCT上观察到13例下肺野背侧少许间质纤维增生,15例空气滞留。结论正常老年人群肺密度变化具有一定特点,但与常规肺功能指标无相关性。     

COPD合并肺间质纤维化患者50例肺通气功能分析

目的分析50例COPD合并肺间质纤维化患者的肺通气功能特点。方法用肺功能自动分析仪分析已确诊的50例COPD合并肺间质纤维化的肺通气功能指标，并与正常参考值比较。结果TLC、RV、RVC基本正常、VC降低、RV／TLC增加，FEV1．0、FEV1．0／FV不成比例下降。结论COPD合并肺间质纤维化的肺通气功能为混合性通气功能障碍。     

术前、术中肺通气功能与术后呼吸衰竭的关系

目的探讨机械通气时呼吸力学与术前肺功能的关系．确定术前通气功能参数能否预测术后呼吸衰竭。方法择期行肺切除术的原发性肺癌病人100例．ASAⅠ级或Ⅱ级，术前测定肺功能：一秒用力呼气容量（FEV1）、用力肺活量（FVC）、一秒用力呼气量与用力肺活量之比（FEV1／FVC％）、最大肺活量（VC）、最大通气量（MVV）、75％肺活量位用力呼气流速（FEh）、最大中期呼气流速（MMEFm）、功能残气量（FRC）、残气量与肺总量之比（RV/TLC％）；测定脉冲震荡肺功能：共振频率（Fres）、呼吸总阻抗（Zres）、中心阻力（Rc）、5Hz和20Hz时粘性阻力（R5、R30）。分别记录插管后机械通气初始和开胸单肺通气后双肺气道峰压（Tpeak）、双肺胸肺顺应性（TCT）和单肺气道峰压（Opeak）、单肺胸肺顺应性（OCT），取其平均值。Opeak和OCT与身高、体重及肺功能的关系采用多元逐步回归。一般情况和肺功能与术后呼吸衰竭的关系采用非条件Logistic回归分析。根据术后是否发生呼吸衰竭分为2组：呼吸衰竭组（RF）和非呼吸衰竭组（NRF）。结果Opeak与Zres、身高、体重和FEF。呈线性关系（R2=0．504），OCT与Zres、身高、VC和RVfrLC％呈线性关系（R^2=0.602）。与NRF组比较，RF组FEV1、FVC、FEV1／FVC％、MVV、MMEFw均降低（P〈0．01）。年龄≥60岁的老年患者FEV1≤60％、FEV1／FVC≤60％、MVV≤50％、MMEn％≤35％时，RF组术后呼吸衰竭发生率高于NRF组（P〈0．05）。Logistic回归表明．年龄和MVV是术后呼吸衰竭的两个主要影响因素。结论术中单肺通气时的气道峰压和胸肺顺应性分别与身高、体重和术前肺功能呈线性相关。中度肺功能减退的老年患者行胸科手术后发生呼吸衰竭的风险性大：年龄和MVV是术后呼吸衰竭的两个主要影响因素。     

Reference values for spirometry,including vital capacity,in Japanese adults calculated with the LMS method and compared with previous values

BackgroundReference values for lung function tests should be periodically updated because of birth cohort effects and improved technology. This study updates the spirometric reference values, including vital capacity (VC), for Japanese adults and compares the new reference values with previous Japanese reference values.MethodsSpirometric data from healthy non-smokers (20,341 individuals aged 17–95 years, 67% females) were collected from 12 centers across Japan, and reference equations were derived using the LMS method. This method incorporates modeling skewness (lambda: L), mean (mu: M), and coefficient of variation (sigma: S), which are functions of sex, age, and height. In addition, the age-specific lower limits of normal (LLN) were calculated.ResultsSpirometric reference values for the 17–95-year age range and the age-dependent LLN for Japanese adults were derived. The new reference values for FEV₁ in males are smaller, while those for VC and FVC in middle age and elderly males and those for FEV₁, VC, and FVC in females are larger than the previous values. The LLN of the FEV₁/FVC for females is larger than previous values. The FVC is significantly smaller than the VC in the elderly.ConclusionsThe new reference values faithfully reflect spirometric indices and provide an age-specific LLN for the 17–95-year age range, enabling improved diagnostic accuracy. Compared with previous prediction equations, they more accurately reflect the transition in pulmonary function during young adulthood. In elderly subjects, the FVC reference values are not interchangeable with the VC values.     

FEV1/FVC ratio of 70% misclassifies patients with obstruction at the extremes of age

BACKGROUND: The American Thoracic Society recommends using the lower limit of normal (LLN) method to diagnose obstructive lung disease. However, few studies have investigated the clinical relevance of these recommendations. We compared the LLN derived from available data sets to a fixed ratio (FEV1/FVC, < 75% or 70%) and also to the FEV1/FVC percent predicted ratio to determine the impact of changing the FEV1/FVC "cutoff" on the spirometric diagnosis of obstructive lung disease. METHODS: FEV1, FVC, FEV1/FVC ratio, age, race, sex, height, and weight were recorded from 1,503 pulmonary function tests. Predicted values were calculated using the Third National Health and Nutrition Examination Study data set (Hankinson), and reference values from studies by Crapo, Knudson, and Morris. In addition, the LLN of the FEV1/FVC ratio was calculated for the Hankinson and Crapo reference values. RESULTS: The number of studies interpreted as obstructed varied from 37% using the Hankinson data set to 55% using the 75% fixed ratio method. Comparing the LLN method vs the 70% fixed ratio method resulted in 7.5% (Hankinson LLN vs 70% fixed) and 6.9% (Crapo LLN vs 70% fixed), which were discordant results. Age was the strongest predictor of discordance, and 16% of subjects > 74 years of age had discordant results comparing Hankinson values to the 70% fixed method. CONCLUSION: At the extremes of age and height, a large number of spirometry test results will be interpreted as showing an obstructive defect if a 70% fixed ratio method is used for interpretation compared with the LLN derived from the Hankinson data set.     

FEV1/FEV6 and FEV6 as an alternative for FEV1/FVC and FVC in the spirometric detection of airway obstruction and restriction

STUDY OBJECTIVES: To evaluate the use of the FEV(1)/forced expiratory volume at 6 s of exhalation (FEV(6)) ratio and FEV(6) as an alternative for FEV(1)/FVC and FVC in the detection of airway obstruction and lung restriction, respectively. SETTING: Pulmonary function laboratory of the Academic Hospital of the Free University of Brussels. PARTICIPANTS: A total of 11,676 spirometric examinations were analyzed on subjects with the following characteristics: white race; 20 to 80 years of age; 7,010 men and 4,666 women; and able to exhale for at least 6 s. METHODS: Published reference equations were used to determine lower limits of normal (LLN) for FEV(6), FVC, FEV(1)/FEV(6), and FEV(1)/FVC. We considered a subject to have obstruction if FEV(1)/FVC was below its LLN. A restrictive spirometric pattern was defined as FVC below its LLN, in the absence of obstruction. From these data, sensitivity and specificity of FEV(1)/FEV(6) and FEV(6) were calculated. RESULTS: For the spirometric diagnosis of airway obstruction, FEV(1)/FEV(6) sensitivity was 94.0% and specificity was 93.1%; the positive predictive value (PPV) and negative predictive value (NPV) were 89.8% and 96.0%, respectively. The prevalence of obstruction in the entire study population was 39.5%. For the spirometric detection of a restrictive pattern, FEV(6) sensitivity was 83.2% and specificity was 99.6%; the PPVs and NPVs were 97.4% and 96.9%, respectively. The prevalence of a restrictive pattern was 15.7%. Similar results were obtained for male and female subjects. When diagnostic interpretation differed between the two indexes, measured values were close to the LLN. CONCLUSIONS: The FEV(1)/FEV(6) ratio can be used as a valid alternative for FEV(1)/FVC in the diagnosis of airway obstruction, especially for screening purposes in high-risk populations for COPD in primary care. In addition, FEV(6) is an acceptable surrogate for FVC in the detection of a spirometric restrictive pattern. Using FEV(6) instead of FVC has the advantage that the end of a spirometric examination is more explicitly defined and is easier to achieve.     

Comparison of Indian reference equations for spirometry interpretation

BACKGROUND AND OBJECTIVES: It would be desirable in a large country such as India that a single set of reference equations be used to interpret lung function tests performed across the entire country. This study compared north, west and south reference equations in interpreting spirometry results in north Indian patients. METHODS: Spirometric records of 27,383 patients aged 16-65 years were assessed. Spirometric values for FVC, FEV(1) and FEV(1)%FVC values derived from north, west and south Indian reference equations were compared. Differences in the lower limit of normal (LLN) were studied across the age and height range of the study group to determine if there was any clinically significant difference in the three derived values. RESULTS: The north and west Indian equations was discordant in 22.1% instances, and the north and south Indian equations in 12.9% instances, with kappa estimates of agreement being 0.626 and 0.781, respectively. Most of the patients with abnormal spirometry using north Indian equations were erroneously interpreted to have normal spirometry using west or south Indian equations. The south Indian equations underpredicted LLN for FVC and FEV(1) for most men and women. The west Indian equations underpredicted LLN for FVC and FEV(1) in all men, and in younger and short statured women. CONCLUSIONS: North, west and south Indian reference equations do not yield equivalent results for spirometry interpretation in north Indian patients.     

The Utility of Spirometry in Diagnosing Pulmonary Restriction

The aim of this retrospective study was to determine the utility of the spirometric measurements FVC, FEV₁, and FEV₁/FVC in diagnosing pulmonary restriction. Spirometry and lung volume measurements performed on the same patient visit were analyzed. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of (1) FVC < lower limit of normal (LLN) (NHANES III reference values) and (2) FVC < LLN and FEV₁/FVC ≥ LLN were compared to diagnose restriction based on lung volume measurements. In all, 18,282 pulmonary function tests from 8,315 patients were analyzed. Twenty-six percent of the patients (n = 2,213) had restriction based on lung volume measurements. The sensitivity, specificity, PPV, and NPV of FVC < LLN to diagnose restriction based on lung volume measurement criteria were 88.6%, 56.8%, 39.9%, and 93.9%, respectively. The sensitivity, specificity, PPV, and NPV of FVC < LLN and FEV₁/FVC ≥ normal to diagnose restriction based on lung volume criteria were 72.4%, 87.1%, 64.4%, and 90.7%, respectively. Analysis of ROC curves showed that spirometric criteria based on FVC alone performed better (area under the curve = 0.817) than those based on the combined criteria of FVC and FEV₁/FVC (area under the curve = 0.584). Consistent with earlier findings, the negative predictive value for a normal FVC (≥ LLN) to exclude pulmonary restriction was high in this series (up to 95.7%). Also, a spirometric diagnosis of “restriction” (FVC < LLN and FEV₁/FVC ≥ LLN) had a positive predictive value of 26.3–73.9%. On this basis, normal FVC can be regarded as excluding restriction with high reliability. Saiprakash B. Venkateshiah and Octavian C. Ioachimescu authors contributed equally to this work.     

Reference values of diffusing capacity of non-smoking Chinese in Hong Kong

BACKGROUND AND OBJECTIVE: This study was conducted to define normal reference values and lower limits of normal (LLN) for single-breath carbon monoxide diffusing capacity (DLco) and DLco per unit of alveolar volume (Kco) for Chinese adults in Hong Kong. METHODS: Healthy non-smoking men and women aged 18-80 years were recruited by random digit dialing. DLco and Kco were measured according to American Thoracic Society standards. Reference equations were obtained by multiple linear regression; LLN were derived by distribution-free method for estimation of age-related centiles. RESULTS: Tests from 568 subjects (259 men, 309 women) were analysed. DLco declined with age in both genders, and increased with height and the interaction term of height and age in men and women, respectively. Considering Hb values did not improve the reference equations. Kco declined with age and increased with weight in both genders, while height and its interaction term with age were additional determinants in women. The reference DLco was lower than some Caucasian values, and was only explained partially by a smaller body size and alveolar volume in Chinese. The distribution-free method yielded better overall approximation to the fifth percentile compared with the traditional method of determining LLN. CONCLUSIONS: The equations for reference values and LLN of diffusing capacity derived in this study are of clinical relevance to Chinese subjects.     

Comparing Spirometric Reference Values From Childhood to Old Age Estimated by LMS and Linear Regression Models

BackgroundProper reference values for lung function testing are essential for achieving adequate interpretations. The LMS procedure (lambda, mu, sigma) permits continuous analyses of entire populations avoiding gaps in the transition between childhood and adulthood. It also allows more precise calculations of average values, dispersion, and 5th percentiles, which are usually considered the lower limit of normality. The objective of this study was to compare our results fitted with the LMS method with standard multiple linear regression, and with those from international Global Lung Function Initiative (GLI) equations.MethodsData from 9835 healthy residents of the metropolitan area of Mexico City aged 8–80 years were compiled from several studies: EMPECE, PLATINO, adult Mexican workers and two unpublished studies. The LMS procedure and multiple linear regression models were fit to obtain reference equations using R software.ResultsResiduals from the LMS models had a median closer to zero, and smaller dispersion than those from the linear model, but differences although statistically significant were very small and of questionable practical relevance. For example, for females and ln(FEV₁), median residual was −0.001 with p25 of −0.08 and p75 of 0.08 for LMS, compared with 0.004 (−0.08, 0.09) [p < 0.05] for the linear model. Average spirometric values for a given height for our population, were higher than those predicted by the GLI study.ConclusionContinuous reference equations for the Mexican population calculated using the LMS technique showed slightly better fit than linear regression models.     

Variability of the prevalence of undiagnosed airflow obstruction in smokers using different diagnostic criteria

PURPOSES: To estimate the prevalence of undiagnosed airflow obstruction (AFO) in Hong Kong smokers with no previous diagnosis of respiratory disease, and to assess its variability when applying different prediction equations and diagnostic criteria. METHODS: A multicenter, population-based, cross-sectional prevalence study was performed in smokers aged 20 to 80 years. Three different criteria (fixed 70% [Global Initiative for Chronic Obstructive Lung Disease and British Thoracic Society], fixed 75%, and European Respiratory Society [ERS]) were applied to define a lower limit of normal (LLN) of the FEV(1)/FVC ratio to compare with the Hong Kong Chinese reference equation (criterion 1), which had used a distribution-free method to obtain the lower fifth percentile of FEV(1)/FVC ratio as the LLN. RESULTS: In 525 male patients, using criterion 1 (local internal prediction equation) and defining AFO as FEV(1)/FVC less than LLN, the overall prevalence of AFO was 13.7%: 8.3% in age > or = 20 to 40 years, 14.0% in age > or = 40 to 60 years, and 17.8% in age > or = 60 to 80 years. When the local internal prediction equation was used as the comparison reference, the fixed-ratio methods tended to miss AFO in younger age groups and overdiagnose AFO in old age, while the ERS criteria, which uses an almost lower fifth percentile-equivalent method, showed less of such a trend but still only showed moderate agreement with criterion 1. CONCLUSIONS: Undiagnosed AFO was prevalent in Hong Kong smokers. Estimated prevalence rates were highly affected by the criteria used to define AFO. The predicted lower fifth percentile values calculated from a local reference equation as the LLN of FEV(1)/FVC ratio should be used for the diagnosis of AFO.     

成年健康个体肾小球滤过率正常范围的研究

目的探讨成年健康个体肾小球滤过率（GFR）的正常范围。方法收集不同地域的成年健康个体,以双血浆法^99m锝-二乙三胺五乙酸（^99mTc—DTPA）血浆清除率为GFR参考值（rGFR）。结果入选健康个体301名。50岁之前rGFR保持恒定;50岁之后rGFR平均每10年下降12．2ml／min。50岁之前女性的rGFR高于男性;〉50岁之后,女性的rGFR均低于男性,但差异无显著性（P〉0．05）。结论50岁以后,成年健康个体GFR真实值随着年龄的增加逐渐下降;50岁之前,女性GFR平均值高于男性。     

Prevalence of Airflow Obstruction in Nonsmoking Older Individuals Using Different Spirometric Criteria: The AGES Reykjavik Study

Abstract

Background: The prevalence and characteristics of airway obstruction in older individuals varies widely with the definition used. We used a random sample of never smoking older population in Iceland to compare the prevalence and clinical profile of subjects diagnosed with Chronic Obstructive Pulmonary Disease (COPD) based on different spirometric criteria. Material and methods: The study uses data from the Age, Gene/Environment Susceptibility–Reykjavik Study, comprising survivors from the Reykjavik Study. Procedures included standardized questionnaires and pre-bronchodilator spirometry for measurement of forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). Results: Total of 495 individuals (150 men and 345 women) met study criteria. Mean age 77 years (range 66-92 years) using fixed ratio (FEV1/FVC < 70%) up to 29% of the population were diagnosed with COPD Stage I. The prevalence of COPD increased with age. Only 7 among 495 (1.4%) were diagnosed with COPD using FEV1/FVC LLN and FEV1 LLN. Conclusion: Application of the GOLD criteria for diagnosis of COPD in older lifelong never smoking subjects identifies a substantial number of non-symptomatic subjects as having COPD. If airway obstruction is defined by FEV1/FVC and FEV1 being below the LLN using appropriate reference equations, only very few non-smoking older individuals fulfill the criteria for COPD.