Reference values for spirometry in Brazilian children
Marcus Herbert Jones, Paula Vidal, Fernanda Cordoba Lanza, Danielle Corrêa França de Melo Franco Silva, Paulo Márcio Pitrez, Ana Paula Bigliardi de Freitas Olmedo, Edjane F. Burity, Kennedy Long Schisler, Leonardo Araújo Pinto, Aline Dill Winck, Edna Lúcia Souza, Anick Augustin Oliveira, Maria Ângela Gonçalves de Oliveira Ribeiro, Lídia Alice Gomes Monteiro Marin Torres, Maria de Fátima B. Pombo March
Abstract
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.