Spirometric reference values for Hopi Native American children ages 4-13 years

Area of Science:

• Pulmonary Medicine
• Pediatric Respiratory Health
• Indigenous Health Research

Background:

• Respiratory diseases contribute significantly to morbidity and mortality in the Hopi Nation.
• Existing spirometry reference equations do not account for the unique physiological characteristics of Hopi children.

Purpose of the Study:

• To determine the necessity of population-specific reference equations for Hopi children.
• To develop new, age- and race-specific pulmonary nomograms for Hopi children.

Main Methods:

• Spirometry was performed on 292 healthy Hopi children (ages 4-13).
• Analyzed pulmonary volumes included forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC, FEF25-75%, and peak expiratory flow rate (PEFR).
• Data were compared with Navajo, Caucasian, Mexican-American, and African-American reference values.

Main Results:

• Height, body mass, and age were significant predictors of FEV1, FVC, and FEF25-75% in gender-specific models.
• Lung function values increased with height and age.
• Hopi-derived equation predictions differed significantly (P≤0.05) from other ethnic group equations for most variables and genders.

Conclusions:

• Population-specific spirometry reference equations are crucial for accurate pulmonary function assessment in Hopi children.
• Existing general reference values may lead to misdiagnosis in this population.
• Development of tailored nomograms is essential for precise pediatric respiratory health evaluation on the Hopi Nation.