title: Changes in the FEV₁/FVC ratio during childhood and adolescence: an intercontinental study.
abstract: In children, the ratio of forced expiratory volume in 1 s (FEV₁) to forced vital capacity (FVC) is reportedly constant or falls linearly with age, whereas the ratio of residual volume (RV) to total lung capacity (TLC) remains constant. This seems counter-intuitive given the changes in airway properties, body proportions, thoracic shape and respiratory muscle function that occur during growth. The age dependence of lung volumes, FEV₁/FVC and RV/TLC were studied in children worldwide. Spirometric data were available for 22,412 healthy youths (51.4% male) aged 4-20 yrs from 15 centres, and RV and TLC data for 2,253 youths (56.7% male) from four centres; three sets included sitting height (SH). Data were fitted as a function of age, height and SH. In childhood, FVC outgrows TLC and FEV₁, leading to falls in FEV₁/FVC and RV/TLC; these trends are reversed in adolescence. Taking into account SH materially reduces differences in pulmonary function within and between ethnic groups. The highest FEV₁/FVC ratios occur in those shortest for their age. When interpreting lung function test results, the changing pattern in FEV₁/FVC and RV/TLC should be considered. Prediction equations for children and adolescents should take into account sex, height, age, ethnic group, and, ideally, also SH.
authors.affiliation: Depts of Pulmonary Diseases and Paediatrics, Erasmus Medical Centre, Erasmus University, Rotterdam, The Netherlands. pquanjer@xs4all.nl
authors.forename: P H
authors.initials: PH
authors.lastname: Quanjer
authors.forename: S
authors.initials: S
authors.lastname: Stanojevic
authors.forename: J
authors.initials: J
authors.lastname: Stocks
authors.forename: G L
authors.initials: GL
authors.lastname: Hall
authors.forename: K V V
authors.initials: KV
authors.lastname: Prasad
authors.forename: T J
authors.initials: TJ
authors.lastname: Cole
authors.forename: M
authors.initials: M
authors.lastname: Rosenthal
authors.forename: R
authors.initials: R
authors.lastname: Perez-Padilla
authors.forename: J L
authors.initials: JL
authors.lastname: Hankinson
authors.forename: E
authors.initials: E
authors.lastname: Falaschetti
authors.forename: M
authors.initials: M
authors.lastname: Golshan
authors.forename: B
authors.initials: B
authors.lastname: Brunekreef
authors.forename: O
authors.initials: O
authors.lastname: Al-Rawas
authors.forename: J
authors.initials: J
authors.lastname: Kühr
authors.forename: Y
authors.initials: Y
authors.lastname: Trabelsi
authors.forename: M S M
authors.initials: MS
authors.lastname: Ip
mesh_terms: D000293:Adolescent; D041923:Adolescent Development; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000254:growth & development* / Q000502:physiology*; D008297:Male; D014797:Vital Capacity; D055815:Young Adult