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Reference standards for forced expiratory indices in Chinese preschool children
Author(s) -
Leung Ting F.,
Liu Tak C.,
Mak Kwok K.,
Su Xuefen,
Sy Hing Y.,
Li Albert M.,
Lau Joseph T.F.,
Lum Sooky,
Wong Gary W.K.
Publication year - 2013
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.22773
Subject(s) - medicine , spirometry , asthma , guideline , pediatrics , physical therapy , reference values , demography , pathology , sociology
Spirometric testing is traditionally achievable in children of school‐age and beyond. Incorporation of interactive incentives motivates preschool children to facilitate measurement of forced expiratory indices. Validated spirometric reference standards are available for Caucasian preschoolers but lacking in Asians. We established spirometric references in Chinese children aged 2–7 years, who were recruited from 19 randomly selected nurseries and kindergartens in Hong Kong. Parents completed International Study of Asthma and Allergies in Childhood questionnaire, and children concurrently performed incentive spirometry on‐site according to international guideline. Prediction equations for spirometric indices were formulated by linear regression. One thousand four hundred two (72.9%) of 1,922 consented children, with mean (SD) age 4.4 (1.0) years, successfully performed spirometry. Following exclusions due to medical and technical reasons, 895 (63.8%) children contributed spirometric data to our references. Girls had lower FEV 0.5 , FEV 0.75 , FEV 1 , FVC, and PEF but similar FEF 25–75 than boys, adjusted for age, weight, and standing height as covariates. Standing height was the most important predictor for FEV 0.5 , FEV 0.75 , FEV 1 , FVC, and PEF in both boys (adjusted R 2 0.525–0.734) and girls (adjusted R 2 0.583–0.721), whereas the best prediction model for both gender is formed by standing height, weight, and age. At various standing heights, our preschoolers had FEV 1 Z ‐scores 0.13–1.00 higher than those of collaborative Caucasian reference. This study justifies the need for ethnic‐specific reference equations and presents spirometry references in young Chinese children. Their forced expiratory indices are determined by gender, age, weight and standing height, and standing height is the best anthropometric index to predict all spirometric indices. Pediatr Pulmonol. 2013; 48:1119–1126. © 2013 Wiley Periodicals, Inc.