A Descriptive Analysis of the Growth and Decline of the FVC and FEV1

doi:10.1378/chest.83.5.717

Chest

Volume 83, Issue 5, May 1983, Pages 717-724

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Using data obtained during the first four complete surveys of a general population sample (2,435 spirometric studies on 916 different asymptomatic nonsmoking subjects), we have derived mathematically continuous equations designed to describe the stages of growth, maturation, and subsequent decline in the forced expiratory volume in one second (FEV>₁) and the forced vital capacity (FVC). With this type of analysis, there appears to be a period from late childhood through adolescence in which maturation significantly increases FVC and FEV₁, independent of growth, and a stage from late adolescence to the early or mid-30s in which there is relatively little change in these measurements. Progressive decline in FVC and FEV₁ may not actually begin until the mid-30s. The mathematical formulae presented here were derived in a manner intended to describe biologic events and are not intended for use as prediction equations. The FEV₁/FVC ratio appeared to be primarily a function of the FVC itself in young subjects. After the age of 33 years, FEV₁/FVC also decreased with age, independent of the size of the FVC.

Section snippets

METHODS

The data analyzed were obtained during the first four complete surveys of the Tucson Epidemiological Study of Airways Obstructive Disease. Details of selection of the study population and of methods for obtaining expiratory flow information have been described.3, 6 Only technically satisfactory spirometric tests on asymptomatic never-smokers are included in the present report. In total, 959 tests in 377 different male subjects and 1,476 tests in 539 different female subjects aged six years or

RESULTS

Simple plots of FVC versus height rounded to the nearest inch indicated clearly that in children there was a nonlinear, apparently exponential relationship between the variables. Log-log analyses were utilized to determine the best exponents for height. It was found that the larger the age span included, the higher the apparent exponent became. Indeed, it was very close to 3.0 (height³) when data for both children and young adults were combined. But regardless of the exponent, OMCVs became

DISCUSSION

Most investigators have noticed an apparent exponential relationship of spirometric measurements to height in children. Present calculations in young children prior to maturation suggest that optimum relationships are obtained with an exponent of height between 2.5 and 2.75, values very similar to those in the summary equations of Polgar and Weng.¹ These exponents would seem biologically reasonable for relating the volumes of lung to total body size per se throughout life. Others have reported

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Association of improved air quality with lung development in children
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In general, the age range of 11 to 15 years captures a period during which lungs are developing rapidly in both boys and girls. Lung-function development continues in girls until their late teens and in boys until their early 20s, but at a much-reduced rate as compared with the rate during the earlier adolescent period.15,16 It is therefore likely that the improved function we observed in the children who were less exposed to the pollutants will persist into their adulthood.
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Supported by a Specialized Center of Research Grant (HL14136) from the National Heart, Lung, and Blood Institute.

Manuscript received July 15; revision accepted November 4

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Chest

Clinical InvestigationsA Descriptive Analysis of the Growth and Decline of the FVC and FEV1

Section snippets

METHODS

RESULTS

DISCUSSION

Respir Physiol

The functional development of the respiratory system from the period of gestation to adulthood

Am Rev Respir Dis

Predictable confusion

J Occup Med

The maximal expiratory flow-volume curve: normal standards, variability, and effects of age

Am Rev Respir Dis

The maximal expiratory flow-volume curve, normal standards, variability, and effects of age (letter to editor)

Am Rev Respir Dis

Reply to letter to editor

Am Rev Respir Dis

Tucson epidemiologic study of obstructive lung diseases: I

methodology and prevalence of disease. Am J Epidemiol

The influence of height on the decline in ventilatory function

Int J Epidemiol

The natural history of chronic bronchitis and emphysema

Clinical Investigations
A Descriptive Analysis of the Growth and Decline of the FVC and FEV₁