Je. Cotes et al., Body mass, fat percentage, and fat free mass as reference variables for lung function: effects on terms for age and sex, THORAX, 56(11), 2001, pp. 839-844
Background-Sex specific cross sectional reference values for lung function
indices usually employ a linear model with terms for age and stature. The e
ffects of also matching for body mass index (BMI = mass/stature(2)) or its
components, fat percentage of body mass (fat%) and fat free mass index (FFM
I = fat free mass/stature(2)) were studied.
Methods-The subjects were 458 asymptomatic male and female non-smokers (383
men) and 22 female ex-smokers. Measurements were made of ventilatory capac
ity, lung volumes, transfer factor (diffusing capacity, single breath CO me
thod), and body composition (skinfold method). Linear and proportional regr
ession models were used.
Results-Terms for fat% and FFMI significantly improved the accuracy of refe
rence values for all the primary lung function indices. The improvements in
subjects with atypical physiques (fat% and FFMI at the ends of the distrib
utions for the subjects) were in the range 0.3-2.3 SD compared with convent
ional regression equations. The new partial regression coefficients on age
were independent of age related changes in body fat. The coefficient for to
tal lung capacity (TLC) on age in men was now positive. Most differences be
tween the sexes were eliminated. A term for BMI improved the descriptions o
f subdivisions of TLC but lacked the other advantages.
Conclusion-Allowance for fat% and FFMI increases the accuracy of reference
equations for lung function, particularly for subjects with a lot of fat an
d little muscle or vice versa. Allowance for BMI is less informative.