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Pulmonary function between 6 and 18 years of age
1Department of Environmental Health, Harvard School of Public Health, Boston, MA 02115.
Insights
This study analyzed lung function in children, revealing that boys and white children generally have higher pulmonary function (forced vital capacity, forced expired volume in 1 second) than girls and black children, respectively. Growth curves and regression equations are provided for accurate assessment.
Area of Science:
- Pediatric Pulmonology
- Growth and Development
- Biostatistics
Background:
- Understanding normal pulmonary function in children is crucial for identifying respiratory abnormalities.
- Existing growth charts may not fully capture the complexities of lung function development during adolescence across different demographics.
Purpose of the Study:
- To establish race- and sex-specific growth curves for key pulmonary function parameters in children aged 6-18 years.
- To develop regression equations for accurate evaluation of longitudinal pulmonary function data in children.
Main Methods:
- Analysis of 82,462 annual pulmonary function measurements (FVC, FEV1, FEF25-75%) from 11,630 white and 989 black children.
- Comparison of median lung function values across race and sex subgroups by age and height.
- Generation of race- and sex-specific percentile distributions and growth curves based on height.
Main Results:
- Boys exhibited higher lung function than girls, and white children showed higher values than black children at similar heights.
- Pulmonary function increased linearly with age until the adolescent growth spurt (around 10 years for girls, 12 for boys).
- The relationship between pulmonary function and height varied with age during adolescence.
Conclusions:
- Race- and sex-specific growth curves of pulmonary function versus height are valuable tools for evaluating individual children's lung function.
- Provided regression equations enable more accurate assessment of adolescent growth and comparison with previous measurements.
- A single growth chart or equation is insufficient for fully describing adolescent lung function development.
Abstract:
Pulmonary function of children aged 6-18 years is described based on 82,462 annual measurements of forced vital capacity (FVC), forced expired volume in 1 second (FEV1), and forced expiratory flow between 25% and 75% of FVC (FEF25-75%) from 11,630 white children and 989 black children. Median height, FVC, FEV1, FEV1/FVC, and FEF25-75% for each 3 months of age are compared among race and sex subgroups. Race- and sex-specific percentile distributions of FVC, FEV1, FEV1/FVC, and FEF25-75% are presented for each centimeter of height (growth curves). For the same height, boys have greater lung function values than girls, and whites have greater ones than blacks. Lung function increases linearly with age until the adolescent growth spurt at about age 10 years in girls and 12 in boys. The pulmonary function vs. height relationship shifts with age during adolescence. Thus, a single equation or the pulmonary function-height growth chart alone does not completely describe growth during the complex adolescent period. Nevertheless, race- and sex-specific growth curves of pulmonary function vs. height make it easy to display and evaluate repeated measures of pulmonary function for an individual child. Race-, sex-, and age-specific regression equations based on height are provided, which permit the evaluation of growth during adolescence with improved accuracy and, more importantly, in comparison with previous observations for the same child.