{"title":"Reference equations for pulmonary function testing in healthy Chinese children aged 4-18 years.","authors":"Jinhong Wu, Hao Zhang, Yufen Wu, Qiaoling Zhang, Ming Li, Fuli Dai, Changfu Xu, Yongsheng Shi, Ning Wang, ChunMei Jia, Sha Liu, Yuehua Zhang, Zhongping Zhang, Aihong Liu, Fei Wang, Li Liu, Qiang Chen, Jinrong Wang, Yuling Han, Yuxin Song, Yong Feng, Yun Sun, Huaping Rao, Lili Zhong, Quanhua Liu, Liya Wan, Zhen Long, Xiaoyan Dong, Yanli Zhang, Wenhui Jiang, Minghong Ji, Jianfeng Huang, Zhiwei Pan, Dongjun Ma, Suping Tang","doi":"10.1186/s12931-025-03298-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Accurate spirometry reference equations are essential for diagnosing and managing respiratory conditions in children. Although the GLI Global Equations have been proposed for general use, there were few Asian populations available for inclusion. This study aims to develop and validate spirometric reference equations for healthy Chinese children.</p><p><strong>Methods: </strong>From May 2018 to May 2021, a cross-sectional study involving healthy Chinese Han children aged 4 to 18 years was conducted by 33 research centers across 24 regions in China. Participants were recruited directly from schools, and physical growth indices (height, weight) were measured. Spirometry tests were performed and demographic and medical history data were collected through questionnaires. New prediction equations were developed using multiple linear regression models with age, height, and weight as predictors. And comparisons were made with existing Caucasian and Chinese pediatric reference equations.</p><p><strong>Results: </strong>Lung function was assessed in 8929 healthy Chinese Han children. Age, weight, and height emerged as strong predictors of lung function (p < 0.001), and sex-specific reference equations incorporating these factors demonstrated high accuracy in internal validation, yielding mean z-scores within a narrow range of -0.004 to -0.069. In comparison, the Zapletal equations overestimated FEV<sub>1</sub> and FEV<sub>1</sub>/FVC while underestimating other lung function parameters. Additionally, the GLI equations underestimated lung function parameters, including FEV<sub>1</sub>, FVC, and FEV<sub>1</sub>/FVC, for both boys and girls. Compared to previous Chinese studies, the z-scores in this study ranged from - 0.97 to 0.93, with some cases showing significant deviations, highlighting the limitations of existing equations.</p><p><strong>Conclusion: </strong>This study developed new spirometry reference equations tailored for healthy Chinese children, with differences noted compared to existing equations. These equations reflect contemporary growth patterns and regional diversity in China, providing an additional option for clinical use.</p><p><strong>Trial registration: </strong>NO.: ChiCTR: 1,800,019,029. Registered 22 October 2018.</p>","PeriodicalId":49131,"journal":{"name":"Respiratory Research","volume":"26 1","pages":"224"},"PeriodicalIF":5.8000,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224709/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Respiratory Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12931-025-03298-3","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Accurate spirometry reference equations are essential for diagnosing and managing respiratory conditions in children. Although the GLI Global Equations have been proposed for general use, there were few Asian populations available for inclusion. This study aims to develop and validate spirometric reference equations for healthy Chinese children.
Methods: From May 2018 to May 2021, a cross-sectional study involving healthy Chinese Han children aged 4 to 18 years was conducted by 33 research centers across 24 regions in China. Participants were recruited directly from schools, and physical growth indices (height, weight) were measured. Spirometry tests were performed and demographic and medical history data were collected through questionnaires. New prediction equations were developed using multiple linear regression models with age, height, and weight as predictors. And comparisons were made with existing Caucasian and Chinese pediatric reference equations.
Results: Lung function was assessed in 8929 healthy Chinese Han children. Age, weight, and height emerged as strong predictors of lung function (p < 0.001), and sex-specific reference equations incorporating these factors demonstrated high accuracy in internal validation, yielding mean z-scores within a narrow range of -0.004 to -0.069. In comparison, the Zapletal equations overestimated FEV1 and FEV1/FVC while underestimating other lung function parameters. Additionally, the GLI equations underestimated lung function parameters, including FEV1, FVC, and FEV1/FVC, for both boys and girls. Compared to previous Chinese studies, the z-scores in this study ranged from - 0.97 to 0.93, with some cases showing significant deviations, highlighting the limitations of existing equations.
Conclusion: This study developed new spirometry reference equations tailored for healthy Chinese children, with differences noted compared to existing equations. These equations reflect contemporary growth patterns and regional diversity in China, providing an additional option for clinical use.
Trial registration: NO.: ChiCTR: 1,800,019,029. Registered 22 October 2018.
期刊介绍：
Respiratory Research publishes high-quality clinical and basic research, review and commentary articles on all aspects of respiratory medicine and related diseases.
As the leading fully open access journal in the field, Respiratory Research provides an essential resource for pulmonologists, allergists, immunologists and other physicians, researchers, healthcare workers and medical students with worldwide dissemination of articles resulting in high visibility and generating international discussion.
Topics of specific interest include asthma, chronic obstructive pulmonary disease, cystic fibrosis, genetics, infectious diseases, interstitial lung diseases, lung development, lung tumors, occupational and environmental factors, pulmonary circulation, pulmonary pharmacology and therapeutics, respiratory immunology, respiratory physiology, and sleep-related respiratory problems.
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