Marcus Herbert Jones1, Paula Cristina Vasconcellos Vidal1, Fernanda Cordoba Lanza2, Danielle Corrêa França de Melo Franco Silva2, Paulo Márcio Pitrez3, Ana Paula Bigliardi de Freitas Olmedo4, Edjane Figueiredo Burity5, Kennedy Long Schisler6, Leonardo Araújo Pinto1, Aline Dill Winck7, Edna Lúcia Santos de Souza8, Anick Augustin Oliveira9, Maria Ângela Gonçalves de Oliveira Ribeiro10, Lidia Alice Gomes Monteiro Marin Torres11, Maria de Fátima Bazhuni Pombo March12, Grupo de Trabalho em Função Pulmonar
J Bras Pneumol.2020;46(3):e20190138
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.
Keywords: Spirometry; Reference values; Child; Child, preschool; Respiratory function tests.