Changes in the FEV1/FVC ratio during childhood and adolescence: An intercontinental study

Adnan Custovic, P. H. Quanjer, S. Stanojevic, J. Stocks, G. L. Hall, K. V V Prasad, T. J. Cole, M. Rosenthal, R. Perez-Padilla, J. L. Hankinson, E. Falaschetti, M. Golshan, B. Brunekreef, O. Al-Rawas, J. Kühr, Y. Trabelsi, M. S M Ip

    Research output: Contribution to journalArticlepeer-review


    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. Copyright©ERS 2010.
    Original languageEnglish
    Pages (from-to)1391-1399
    Number of pages8
    JournalEuropean Respiratory Journal
    Issue number6
    Publication statusPublished - 1 Dec 2010


    • Ethnicity
    • Growth and development
    • Lung volume measurements
    • Sitting height
    • Thorax


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