Journal Information
Vol. 44. Issue 6.
Pages 295-302 (January 2008)
Share
Share
Download PDF
More article options
Vol. 44. Issue 6.
Pages 295-302 (January 2008)
Original Articles
Full text access
Lung Function Reference Values in Children and Adolescents Aged 6 to 18 Years in Galicia
Visits
8375
Francisco Javier González Barcalaa,
Corresponding author
fjgbarcala@telefonica.net

Correspondence: Dr F.J. Álvarez-Gutiérrez Servicio de Neumoloxía, Complexo Hospitalario Clínico Universitario Choupana, s/n, 15706 Teo, A Coruña, Spain
, Carmen Cadarso Suárezb, Luis Valdés Cuadradoa, Rosaura Leisc, Rodrigo Cabanasc, Rafael Tojoc
a Servicio de Neumoloxía, Complexo Hospitalario Clínico Universitario, Santiago de Compostela, A Coruña, Spain
b Departamento de Bioestadística e Investigación Operativa, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
c Departamento de Pediatría, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
This item has received
Article information
Abstract
Bibliography
Download PDF
Statistics
Objective

It is well known that lung function referencevalues differ between populations, hence the apparentimportance of establishing such values. The aim of thisstudy was to develop prediction equations for spirometryfor healthy children and adolescents in Galicia, Spain.

Population and methods

We studied children andadolescents aged 6 to 18 years from randomly selectedschools in 14 municipalities in Galicia. Spirometric valueswere measured following the protocols established by the American Thoracic Society in 1987, with real-timemonitoring of flow-volume curves. The prediction equationswere derived using multivariate linear regression.

Results

We developed equations to predict the mainspirometry parameters for this age group according to sex, height, and weight. Mean spirometry values in relation toheight were higher for boys than for girls, except in the 140-160 cm range, where they were higher for girls. Equations published in other studies in similar populationsgave different predictions, ranging from an underestimationof forced midexpiratory flow rate (FEF25%-75%) by 16% incomparison to ours to an overestimation of peak expiratoryflow (PEF) rate by 15% for an average boy. For a girl, thecorresponding differences ranged from an underestimationof FEF25%-75% by 17% to an overestimation of PEF by 19%.

Conclusions

These results support the importance ofusing population-specific prediction equations to establishlung function reference values.

Key words:
Spirometry
Healthy children
Reference values
Objetivo

Son conocidas las diferencias entre distintaspoblaciones en cuanto a los valores de referencia de la fun-ción respiratoria, por lo cual parece importante establecer-los. El objetivo del estudio ha sido establecer las ecuacionesde predicción de parámetros espirométricos en niños y ado-lescentes sanos de Galicia.

Población y métodos

Hemos estudiado a niños y adoles-centes sanos de 6 a 18 años de edad, de colegios seleccionadosaleatoriamente en 14 municipios de Galicia. Las maniobrasespirométricas se realizaron de acuerdo con los protocolos dela American Thoracic Society de 1987, con evaluación conti-nua de los espirogramas. Se obtuvieron las ecuaciones depredicción mediante regresión lineal multivariante.

Resultados

Con este estudio se obtuvieron las ecuaciones depredicción de los principales parámetros espirométricos en estegrupo de edad, en función de la edad, el sexo, la talla y el peso. Los valores medios de los parámetros espirométricos, en funciónde la estatura, son superiores en la población masculina com-parada con la femenina, excepto en el rango entre 140 y 160 cmde altura, donde las mujeres superan a los varones. Para unvarón medio de nuestra población, los parámetros de funciónpulmonar obtenidos con las ecuaciones de predicción referidaspor otros autores en poblaciones similares difieren de los nues-tros, desde una infraestimación de un 16% para el flujo mesoes-piratorio forzado hasta una sobreestimación de un 15% para elpico de flujo espiratorio; para una mujer, las discrepancias vandesde la infraestimación del flujo mesoespiratorio forzado del 17%hasta la sobreestimación del pico de flujo espiratorio de un 19%.

Conclusiones

Estos resultados refuerzan la importanciade utilizar ecuaciones de predicción específicas para cadapoblación.

Palabras clave:
Espirometría forzada
Niños sanos
Valores dereferencia
Full text is only aviable in PDF
References
[1]
American Thoracic Society.
Lung function testing: selection of reference values and interpretative strategies. ATS Statement.
Am Rev Respir Dis, 144 (1991), pp. 1202-1218
[2]
X Wang, DW Dockery, D Wypij, DR Gold, FE Speizer, JH Ware, et al.
Pulmonary function growth velocity in children 6 to 18 years of age.
Am Rev Respir Dis, 148 (1993), pp. 1502-1508
[3]
JL Hankinson, JR Odencrantz, KB Fedan.
Spirometric reference values from a sample of the general U.S. population.
Am J Respir Crit Care Med, 159 (1999), pp. 179-187
[4]
A Parma, N Magliocchetti, A Spagnolo, A Di Monaco, MR Migliorino, A Menotti.
Spirometric prediction equations for male Italians 7-18 years of age.
Eur J Epidemiol, 12 (1996), pp. 263-277
[5]
A Greenough, MF Hird, L Everett, JF Price.
Importance of using lung function regression equations appropriate for ethnic origin.
Pediatr Pulmonol, 11 (1991), pp. 207-211
[6]
S Hellmann, AI Goren.
The necessity of building population specific prediction equations for clinical assessment of pulmonary function tests.
Eur J Pediatr, 158 (1999), pp. 519-522
[7]
X Wang, DW Dockery, D Wypij, ME Fay, BG Ferris Jr.
Pulmonary function between 6 and 18 years of age.
Pediatr Pulmonol, 15 (1993), pp. 75-88
[8]
JM Tanner, T Hayashi, MA Preece, N Cameron.
Increase in length of leg relative to trunk in Japanese children and adults from 1957 to 1977: comparison with British and with Japanese Americans.
Ann Hum Biol, 9 (1982), pp. 411-423
[9]
JD Schwartz, SA Katz, RW Fegley, MS Tockman.
Analysis of spirometric data from a national sample of healthy 6- to 24-year- olds (NHANES II).
Am Rev Respir Dis, 138 (1988), pp. 1405-1414
[10]
J Schwartz, SA Katz, RW Fegley, MS Tockman.
Sex and race differences in the development of lung function.
Am Rev Respir Dis, 138 (1988), pp. 1415-1421
[11]
R Leis, P Pavon, T Queiro, D Recarey, R Tojo.
Atherogenic diet and blood lipid profile in children and adolescents from Galicia, NW Spain. The Galinut Study.
Acta Paediatr, 88 (1999), pp. 19-23
[12]
LM Taussig, V Chernick, R Wood, P Farrell, RB Mellins.
Standardization of lung function testing in children. Proceedings and recommendations of the GAP Conference Committee, Cystic Fibrosis Foundation.
J Pediatr, 97 (1980), pp. 668-676
[13]
American Thoracic Society.
Standardization of spirometry: 1987 update. ATS Statement.
Am Rev Respir Dis, 136 (1987), pp. 1285-1298
[14]
WS Cleveland.
Robust locally weighted regression and smoothing scatterplots.
J Am Stat Assoc, 74 (1979), pp. 829-836
[15]
TJ Cole, JV Freeman, MA Preece.
British 1990 growth reference centiles for weight, height, body mass index and head circumference fitted by maximum penalized likelihood.
Stat Med, 17 (1998), pp. 407-429
[16]
R Pérez-Padilla, J Regalado-Pineda, M Rojas, M Catalán, L Mendoza, R Rojas, et al.
Spirometric function in children of Mexico City compared to Mexican-American children.
Pediatr Pulmonol, 35 (2003), pp. 177-183
[17]
H Manzke, E Stadlober, HP Schellauf.
Combined body plethysmographic, spirometric and flow volume reference values for male and female children aged 6 to 16 years obtained from “hospital normals”.
Eur J Pediatr, 160 (2001), pp. 300-306
[18]
M Rosenthal, SH Bain, D Cramer, P Helms, D Denison, A Bush, et al.
Lung function in white children aged 4 to 19 years: I – spirometry.
Thorax, 48 (1993), pp. 794-802
[19]
S Chinn, RJ Rona.
Height and age adjustment for cross sectional studies of lung function in children aged 6-11 years.
Thorax, 47 (1992), pp. 707-714
[20]
P Casan.
Valores de referencia en la espirometría forzada para niños y adolescentes sanos [doctoral thesis], Facultad de Medicina. Universidad Autónoma de Barcelona, (1985),
[21]
DB Coultas, CA Howard, BJ Skipper, JM Samet.
Spirometric prediction equations for Hispanic children and adults in New Mexico.
Am Rev Respir Dis, 138 (1988), pp. 1386-1392
[22]
J Sanz Ortega, A Martorell Aragonés, A Álvarez Ángel, JD Bermúdez Edo, JI Carrasco Moreno, R Saiz Rodríguez, et al.
Estudio de la función pulmonar basal (FVC, FEV1) en una población infantil de referencia.
An Esp Pediatr, 32 (1990), pp. 507-512
[23]
J Sanz Ortega, A Martorell Aragonés, A Álvarez Ángel, JD Bermúdez Edo, JI Carrasco Moreno, R Saiz Rodríguez, et al.
Estandarización de la espirometría forzada. Análisis de la función pulmonar basal (PEF, FEF25-75, FEF50) en una población infantil de referencia.
An Esp Pediatr, 32 (1990), pp. 499-506
[24]
MD Morato Rodríguez, E González Pérez-Yarza, JI Emparanza Knörr, A Pérez Legorboru, A Aguirre Conde, A Delgado Rubio.
Valores espirométricos en niños y adolescentes sanos de un área urbana de la Comunidad Autónoma Vasca.
An Esp Pediatr, 51 (1999), pp. 17-21
[25]
Y Trabelsi, H Ben Saad, Z Tabka, N Gharbi, A Bouchez Buvry, JP Richalet, et al.
Spirometric reference values in Tunisian children.
Respiration, 71 (2004), pp. 511-518
[26]
DJ Chinn, JE Cotes, AJ Martin.
Modelling the lung function of Caucasians during adolescence as a basis for reference values.
Ann Hum Biol, 33 (2006), pp. 64-77
[27]
MS Ip, EM Karlberg, JP Karlberg, KD Luk, JC Leong.
Lung function reference values in Chinese children and adolescents in Hong Kong. I. Spirometric values and comparison with other populations.
Am J Respir Crit Care Med, 162 (2000), pp. 424-429
[28]
GJ Connett, SH Quak, ML Wong, J Teo, BW Lee.
Lung function reference values in Singaporean children aged 6-18 years.
Thorax, 49 (1994), pp. 901-905
[29]
DL Sherrill, A Camilli, MD Lebowitz.
On the temporal relationships between lung function and somatic growth.
Am Rev Respir Dis, 140 (1989), pp. 638-644
[30]
KL Andersen, J Rutenfranz, V Seliger, J Ilmarinen, I Berndt, H Kylian, et al.
The growth of lung volumes affected by physical performance capacity in boys and girls during childhood and adolescence.
Eur J Appl Physiol Occup Physiol, 52 (1984), pp. 380-384
[31]
GJ Borsboom, W van Pelt, PH Quanjer.
Pubertal growth curves of ventilatory function: relationship with childhood respiratory symptoms.
Am Rev Respir Dis, 147 (1993), pp. 372-378
[32]
PC Schrader, PH Quanjer, BC Van Zomeren, ME Wise.
Changes in the FEV1-height relationship during pubertal growth.
Bull Eur Physiopathol Respir, 20 (1984), pp. 381-388
[33]
EI Mohamed, C Maiolo, L Iacopino, M Pepe, N Di Daniele, A De Lorenzo.
The impact of body-weight components on forced spirometry in healthy Italians.
[34]
R Lazarus, G Colditz, CS Berkey, FE Speizer.
Effects of body fat on ventilatory function in children and adolescents: cross-sectional findings from a random population sample of school children.
Pediatr Pulmonol, 24 (1997), pp. 187-194
[35]
FJ González Barcala, B Takkouche, L Valdés, R Leis, P Álvarez Calderón, R Cabanas, et al.
Body composition and respiratory function in healthy non-obese children.
Pediatr Int, 49 (2007), pp. 553-557
[36]
R Lazarus, CJ Gore, M Booth, N Owen.
Effects of body composition and fat distribution on ventilatory function in adults.
Am J Clin Nutr, 68 (1998), pp. 35-41
[37]
F Pistelli, M Bottai, G Viegi, F Di Pede, L Carrozzi, S Baldacci, et al.
Smooth reference equations for slow vital capacity and flow-volume curve indexes.
Am J Respir Crit Care Med, 161 (2000), pp. 899-905
[38]
AD Rogol, JN Roemmich, PA Clark.
Growth at puberty.
J Adolesc Health, 31 (2002), pp. 192-200
[39]
EN Pattishall.
Pulmonary function testing reference values and interpretations in pediatric training programs.
Pediatrics, 85 (1990), pp. 768-773
[40]
P Subbarao, P Lebecque, M Corey, AL Coates.
Comparison of spirometric reference values.
Pediatr Pulmonol, 37 (2004), pp. 515-522
[41]
W Gernand, P Dumnicka, B Kunierz-Cabala, M Kapusta, B Solnica.
Lower confidence limits for critical systematic errors.
Clin Biochem, 40 (2007), pp. 1317-1320
[42]
MJ Krowka, PL Enright, JR Rodarte, RE Hyatt.
Effect of effort on measurement of forced expiratory volume in one second.
Am Rev Respir Dis, 136 (1987), pp. 829-833
[43]
JM Tanner, RH Whitehouse.
Clinical longitudinal standards for height, weight, height velocity, weight velocity, and stages of puberty.
Arch Dis Child, 51 (1976), pp. 170-179
[44]
RJ Knudson, MD Lebowitz, CJ Holberg, B Burrows.
Changes in the normal maximal expiratory flow-volume curve with growth and aging.
Am Rev Respir Dis, 127 (1983), pp. 725-734
[45]
O Brandli, C Schindler, N Kunzli, R Keller, AP Perruchoud.
Lung function in healthy never smoking adults: reference values and lower limits of normal of a Swiss population.
Thorax, 51 (1996), pp. 277-283

This study was partially funded by the Xunta de Galicia (60904.44055). Dr Cadarso's statistical work was financed with grants from the Spanish Ministry of Education and Science in collaboration with the European Regional Development Fund (MTM2005-00818).

Copyright © 2008. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?