The assessment and interpretation of spirometry during the transition from childhood to adulthood

Lebowitz, Michael D.; Sherrill, Duane L.

doi:10.1002/ppul.1950190210

Cited by 24 publications

(13 citation statements)

References 44 publications

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“…These data, although cross-sectional, suggest that, in the present group of males, lung and thoracic development was still occurring, whereas it was almost complete in the females. This is in agreement with the data of LEBOWITZ and SHERRILL [3] showing that, in males, lung and thoracic development is observed during and until the end of puberty. Conversely, in females, lung development occurs over a shorter period of time and earlier in the pubertal process.…”

Section: Discussionsupporting

confidence: 82%

“…At adolescence, lung function no longer increases proportionally to height but rather follows a more complex pattern. Initially, trunk length lags behind leg length temporally; then the lung grows in diameter followed by length [3]; and, finally, lung volumes continue to increase after adult height has been reached due to prolonged increase in muscle strength [4][5][6]. Therefore, lung function increases proportionally to trunk and chest dimension rather than to height [7].…”

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confidence: 99%

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Lung and thorax development during adolescence: relationship with pubertal status

Nève¹,

Girard²,

Flahault³

et al. 2002

Eur Respir J

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The aim of the present study was to define reference values for lung volumes and the lung transfer factor for carbon monoxide (TL,CO) for an adolescent population using thoracic volume index (TVI) and an index of pubertal stage in order to account for the variation in growth pattern between adolescents.TVI, pubertal stage by Tanner scale (PST), time since menarche, functional residual capacity measured using the helium-dilution technique, vital capacity, total lung capacity and TL,CO measured using a steady-state method were determined in 51 males (aged 13-20 yrs; PST T3-T5) and 52 females (aged 13-18 yrs; PST T2-T4; all but three had already undergone menarche).In male adolescents, height, weight, TVI, lung volumes and TL,CO increased with age. This was not the case in female adolescents. In males, the TVI was the independent variable that best correlated with pulmonary volumes. In females, height was the independent variable that best correlated with pulmonary volumes. In both sexes, the variable that best correlated with TL,CO was PST, associated with height in males.This cross-sectional study provides prediction equations for lung volumes and the lung transfer factor for carbon monoxide taking into account thoracic volume index and pubertal stage. It shows that, in adolescent males, lung and thoracic development occurs during and until the end of puberty. Conversely, in adolescent females, lung development is almost finished following menarche.

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Section: Discussionsupporting

confidence: 82%

mentioning

confidence: 99%

Lung and thorax development during adolescence: relationship with pubertal status

Nève¹,

Girard²,

Flahault³

et al. 2002

Eur Respir J

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“…Since investigation of sex effects involves comparing lungs of different sizes, a major issue has been how to compare the function of lungs of different sizes—that is, how to “standardise” for size differences. In other words, given the considerable within and between gender variation in growth rates and in the patterns of growth,15 24 32 36 37 should lung or somatic size be the reference? The data underlying the answers to some of these issues are summarised in tables 1 15 24 27 32 and 2 15…”

Section: Dimensional Determinants Of Airway Behaviour and Structure/fmentioning

confidence: 99%

“…In other words, given the considerable within and between gender variation in growth rates and in the patterns of growth,15 24 32 36 37 should lung or somatic size be the reference? The data underlying the answers to some of these issues are summarised in tables 1 15 24 27 32 and 2 1524-27 29-31 38-43 Although only human data are cited, they are backed by a considerable body of experimental animal data well documented elsewhere 8…”

Section: Dimensional Determinants Of Airway Behaviour and Structure/fmentioning

confidence: 99%

Gender differences in airway behaviour over the human life span

Becklake

Kauffmann²

1999

Thorax

593

440

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“…There is also the benefit of a seamless transition from childhood to adulthood using the same equations (GLI 2012), which removes the complication of switching to adult equations during longitudinal monitoring of patients with diseases such as cystic fibrosis [13]. There are many simultaneous factors such as height, growth and anatomical changes to consider when determining reference equations across adolescence [14]. In 2008, STANOJEVIC et al [15] produced the first spirometry reference equations that provided smooth transition curves from childhood through adolescence during rapid growth and adulthood (age range 4-80 years).…”

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confidence: 99%

Adopting universal lung function reference equations

Swanney

Miller

2013

Eur Respir J

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@ERSpublicationsAdopting the GLI 2012 lung function reference equations is an essential and urgent task for laboratories worldwide http://ow.ly/nIoykSince the dawn of spirometry and testing lung function [1,2], clinicians have been aware that the values obtained from testing an individual's lung function can reflect the effects of lung diseases, and that this can be helpful with regard to all aspects of disease prevention and management. It was also recognised that the values obtained were also a reflection of the subject's sex, age and height; so to maximise the clinically relevant signal from the tests these aspects first needed to be taken into account. Studies were then undertaken to record lung function in subjects free from disease and free from the effects of tobacco smoke in order to have reference ranges of lung function.Clinicians have had to decide which of the many available prediction equations to use for their patients, realising that the different equations might lead to different judgements about the results obtained, because predicted values might vary by as much as 1 L for forced expiratory volume in 1 s (FEV1) [3]. Guidance in this choice has been based on the reference population being appropriate for the patients and the equipment used for recording the lung function being equivalent. Other considerations include the age span of the reference population and the statistical approach used to derive the various predicted equations. Many European centres used the equations derived for the European Community for Steel and Coal (ECSC) [4]. However, it was still evident that different hospitals in a given locality might use very different prediction equations [5], meaning a patient's outcome might vary depending on which hospital they were tested at.The Global Lung Initiative (GLI) was set up by the European Respiratory Society in 2010 with the remit to produce spirometry prediction equations that spanned all ages and could be used globally. These equations (GLI 2012) have been successfully produced [6] to the benefit of patients worldwide. Great credit should be given to the team that worked diligently to deliver these on time. Since the publication of the GLI 2012 prediction equations there have been validation studies undertaken in a wide range of ethnicities in British children [7] and in an Australasian population between 4-80 years [8], and these have shown that the GLI 2012 equations were appropriate.In this issue of the European Respiratory Journal, QUANJER et al. [9] outline the possible effect that changing to the GLI 2012 equations might have in clinical practice. In this study, the authors compared hospital spirometry data in adults from Australia and Poland using the GLI 2012, ECSC and National Health and Nutrition Examination study (NHANES III) [10] prediction equations. The authors found that the GLI 2012 equations gave predictions similar to NHANES III values but were higher than ECSC. While there was little difference in identifying an obstructive spirometric pattern, the frequenc...

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The assessment and interpretation of spirometry during the transition from childhood to adulthood

Cited by 24 publications

References 44 publications

Lung and thorax development during adolescence: relationship with pubertal status

Lung and thorax development during adolescence: relationship with pubertal status

Gender differences in airway behaviour over the human life span

Adopting universal lung function reference equations

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