Lung function changes from childhood to adolescence: a seven-year follow-up study

Abstract

BackgroundAs part of an investigation into the respiratory health in children conducted in Torino, northwestern Italy, our aim was to assess development in lung function from childhood to adolescence, and to assess changes or persistence of asthma symptoms on the change of lung function parameters. Furthermore, the observed lung function data were compared with the Global Lung Function Initiative (GLI) reference values.MethodsWe conducted a longitudinal study, which lasted 7 years, composed by first survey of 4–5 year-old children in 2003 and a follow-up in 2010. Both surveys consisted in collecting information on health by standardized SIDRIA questionnaire and spirometry testing with FVC, FEV1, FEV1/FVC% and FEF25–75 measurements.Results242 subjects successfully completed both surveys. In terms of asthma symptoms (AS = asthma attacks or wheezing in the previous 12 months), 191/242 were asymptomatic, 13 reported AS only in the first survey (early transient), 23 had AS only in the second survey (late onset), and 15 had AS in both surveys (persistent). Comparing the lung function parameters observed with the predicted by GLI only small differences were detected, except for FVC and FEF25–75, for which more than 5% of subjects had Z-score values beyond the Z-score normal limits. Furthermore, as well as did not significantly affect developmental changes in FVC and FEV1, the decrease in FEV1/FVC ratio was significantly higher in subjects with AS at the time of follow-up (late onset and persistent phenotypes) while the increase in FEF25–75 was significantly smaller in subjects with persistent AS (p < 0.05).ConclusionsThe GLI equations are valid in evaluating lung function during development, at least in terms of lung volume measurements. Findings also suggest that the FEF25–75 may be a useful tool for clinical and epidemiological studies of childhood asthma.

How applicable are GLI 2012 equations to a sample of Middle Eastern school‐age children?

“…To summarize, the results of this study indicated that similar to other studies conducted in several countries in Europe, 26‐28 the GLI 2012 equations for Caucasians demonstrated a reasonable fit to our data; as the study results indicate that the Caucasian equation was more suitable for the Jordanian school‐aged children when compared with the other or mixed. This contraindicate our previous results 29 that found that the GLI 2012 for other or mixed was a better representation to the adult Jordanian when compared with the Caucasian equation, this emphasizes the importance of evaluating the applicability of GLI 2012 Caucasians and other or mixed to older children in Jordan and highlights the importance of long‐term longitudinal studies to evaluate changes occurring in lung growth and factors that may influence it in Jordan.…”

“…To summarize, the results of this study indicated that similar to other studies conducted in several countries in Europe, [26][27][28]…”

Valores espirométricos en pre-escolares sanos

“…También se consideraron 20 espirometrías que tenían tiempo espiratorio menor a 1 segundo, utilizando los valores de VEF 0,5 y VEF 0,75 para sus fórmulas predictivas correspondientes. Los niños menores de 6 años aún tienen su pulmón en etapa de crecimiento, las vías aéreas son relativamente más grandes que el parénquima pulmonar, lo que explicaría un vaciamiento rápido con la espiración forzada, con un final brusco y precoz 8,11,27 . Los niños a esta edad pueden expresar su CVF con espiraciones menores a 1 segundo, obteniendo valores de VEF 0,5 y VEF 0,75 , los cuales tienen buena reproducibilidad y son útiles para evaluar respuesta a broncodilatador [28][29][30]37 .…”

“…En este sentido pudimos realizar comparación con las fórmulas GLI mediante z score, mostrando que no había diferencia significativa. Al realizar regresiones múltiples, se encontró que la talla fue el factor más determinante de cada variable de función pulmonar, al igual que se ha encontrado en estudios previos 4,10,13,16,27 . También, en forma semejante a estos estudios, los coeficientes de correlación (r 2 ) resultaron moderados entre talla y volúmenes y bajos para relaciones VEF t /CVF y flujos espiratorios forzados (Tabla 4).…”

Changes of DNA methylation are associated with changes in lung function during adolescence

“…The period from childhood to adolescence is associated with rapid somatic growth and incorporates a range of gender-dependent physiological and behavioral changes, including hormonal, height and body mass index (BMI) changes, possible use of oral contraceptives, and possible initiation of nicotine use [1,2]. This period is also significant for the development of lung function as it represents a phase of dramatic growth from childhood to adolescence to reach a maximal level of lung function in early adulthood [3][4][5]. Lung function growth is genderdependent and such dependence is attributable to multiple biological determinants, including dimensional/ anatomical (e.g., airway size, somatic growth, lung growth, adolescence growth spurts), immunological, and hormonal determinants such as different phases of the menstrual cycle and common hormonal and metabolic conditions [6][7][8][9].…”