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. 2020 Mar 27;46(3):e20190138.
doi: 10.36416/1806-3756/e20190138. eCollection 2020.

Reference values for spirometry in Brazilian children

[Article in English, Portuguese]
Marcus Herbert Jones  1 , Paula Cristina Vasconcellos Vidal  1 , Fernanda Cordoba Lanza  2 , Danielle Corrêa França de Melo Franco Silva  2 , Paulo Márcio Pitrez  3 , Ana Paula Bigliardi de Freitas Olmedo  4 , Edjane Figueiredo Burity  5 , Kennedy Long Schisler  6 , Leonardo Araújo Pinto  1 , Aline Dill Winck  7 , Edna Lúcia Santos de Souza  8 , Anick Augustin Oliveira  9 , Maria Ângela Gonçalves de Oliveira Ribeiro  10 , Lidia Alice Gomes Monteiro Marin Torres  11 , Maria de Fátima Bazhuni Pombo March  12 ; Grupo de Trabalho em Função Pulmonar
Affiliations
Free PMC article

Reference values for spirometry in Brazilian children

[Article in English, Portuguese]
Marcus Herbert Jones et al. J Bras Pneumol. .
Free PMC article

Abstract
in English, Portuguese

Objective: To generate reference values for spirometry in Brazilian children 3-12 years of age and to compare those values with the values employed in the equations currently in use in Brazil.

Methods: This study involved healthy children, 3-12 years of age, recruited from 14 centers (primary data) and spirometry results from children with the same characteristics in six databases (secondary data). Reference equations by quantile regressions were generated after log transformation of the spirometric and anthropometric data. Skin color was classified as self-reported by the participants. To determine the suitability of the results obtained, they were compared with those predicted by the equations currently in use in Brazil.

Results: We included 1,990 individuals from a total of 21 primary and secondary data sources. Of those, 1,059 (53%) were female. Equations for FEV1, FVC, the FEV1/FVC ratio, FEF between 25% and 75% of the FVC (FEF25-75%) and the FEF25-75%/FVC ratio were generated for white-, black-, and brown-skinned children. The logarithms for height and age, together with skin color, were the best predictors of FEV1 and FVC. The reference values obtained were significantly higher than those employed in the equations currently in use in Brazil, for predicted values, as well as for the lower limit of normality, particularly in children with self-reported black or brown skin.

Conclusions: New spirometric equations were generated for Brazilian children 3-12 years of age, in the three skin-color categories defined. The equations currently in use in Brazil seem to underestimate the lung function of Brazilian children 3-12 years of age and should be replaced by the equations proposed in this study.

Objetivo:: Gerar valores de referência para espirometria em crianças brasileiras de 3-12 anos de idade e comparar os resultados obtidos com as equações em uso no Brasil.

Métodos:: Foram incluídas crianças sadias de 3-12 anos recrutadas em 14 centros (dados primários) e resultados de espirometria de crianças com as mesmas características de seis bancos de dados (dados secundários). As equações quantílicas foram geradas após transformações logarítmicas dos dados espirométricos e antropométricos. A classificação por cor da pele foi autodeclarada. Os resultados obtidos foram comparados com os previstos nas equações em uso no Brasil para testar sua adequação.

Resultados:: Foram incluídos 1.990 indivíduos de 21 fontes de dados primários e secundários, sendo 1.059 (53%) do sexo feminino. Equações para VEF1, CVF, VEF1/CVF, FEF25-75% e FEF25-75%/CVF foram geradas para crianças brancas e para crianças negras e pardas. Os logaritmos da estatura e da idade e a cor da pele foram os melhores preditores para VEF1 e CVF. Os resultados obtidos foram significativamente maiores do que as estimativas geradas pelas equações em uso no Brasil, tanto para valores previstos quanto para o limite inferior da normalidade, particularmente em crianças negras e pardas.

Conclusões:: Novas equações espirométricas foram geradas para crianças brasileiras de 3-12 anos de cor branca, negra e parda. As equações atualmente em uso no Brasil parecem subestimar a função pulmonar de crianças brasileiras menores de 12 anos de idade e deveriam ser substituídas pelas equações propostas neste estudo.

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Figures

Figure 1
Figure 1. Lung function variables versus height in white children and in brown and black children (male: A and B, female: C and D), showing the 50th percentile (thick line) and the 5th percentile (thin line) for FEV1 (A and C) and FVC (B and D).
Figure 2
Figure 2. FEV1/FVC ratio (A) and FEF25-75% (B) versus height in white and black/brown male and female children, showing the 50th percentile (thick line) and the 5th percentile (thin line).
See this image and copyright information in PMC

Comment in

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