Reference values of aerobic fitness in the contemporary paediatric population: VO2max Z-scores

We studied the fit of the Global Lung Function Initiative (GLI) all-age reference values to Norwegians, compared them with currently used references (European Community for Steel and Coal (ECSC) and Zapletal) and estimated the prevalence of obstructive lung disease.Spirometry data collected in 30 239 subjects (51.7% females) aged 12–90 years in three population-based studies were converted to z-scores.We studied healthy non-smokers comprising 2438 adults (57.4% females) aged 20–90 years and 8725 (47.7% female) adolescents aged 12–19 years. The GLI-2012 prediction equations fitted the Norwegian data satisfactorily. Median±sd z-scores were respectively 0.02±1.03, 0.01±1.04 and −0.04±0.91 for forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC in males, and −0.01±1.02, 0.07±0.97 and −0.21±0.82 in females. The ECSC and Zapletal references significantly underestimated FEV1 and FVC. Stricter criteria of obstruction (FEV1/FVC <GLI-2012 lower limit of normal (LLN)) carried a substantially higher risk of obstructive characteristics than FEV1/FVC <0.7 and >GLI-2012 LLN. Corresponding comparison regarding myocardial infarction showed a four-fold higher risk for women.The GLI-2012 reference values fit the Norwegian data satisfactorily and are recommended for use in Norway. Correspondingly, the FEV1/FVC GLI-2012 LLN identifies higher risk of obstructive characteristics than FEV1/FVC <0.7.

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Erratum for Koestenberger, et al. “Reference values and calculation of z-scores of echocardiographic measurements of the normal pediatric right ventricle” Am J Cardiol 2014;114:1590–1598

The American Journal of Cardiology ◽

10.1016/j.amjcard.2015.10.023 ◽

2016 ◽

Vol 117 (2) ◽

pp. 317

Keyword(s):

Right Ventricle ◽

Reference Values ◽

Z Scores

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Abstract 170: Re-evaluation of Carotid Intima-Media Thickness by Z-score in Children and Adolescents After Kawasaki Disease

Circulation ◽

10.1161/circ.131.suppl_2.170 ◽

2015 ◽

Vol 131 (suppl_2) ◽

Author(s):

Nobutaka Noto ◽

Masataka Kato ◽

Yuriko Abe ◽

Hiroshi Kamiyama ◽

Kensuke Karasawa ◽

...

Keyword(s):

Kawasaki Disease ◽

Children And Adolescents ◽

Reference Values ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Specific Reference ◽

Healthy Children ◽

Media Thickness ◽

Z Scores ◽

The Mean

Objectives: The carotid intima-media thickness (CIMT) is a reliable screening method for vascular alterations even in a pediatric cohort; however, reference values of CIMT established recently by LMS methods for childhood and adolescence are limited when comparing patients after Kawasaki disease (KD) and controls. We tested the hypothesis that there are significant differences between the values of CIMT expressed as absolute values and z-scores in children and adolescents after KD and controls. Methods: We reviewed 12 published articles regarding CIMT on patients after KD and controls. Absolute values (Ab) of the mean±1 SD of CIMT in patients after KD and controls were transformed to z-scores (Zs) using age-specific reference values established by Jourdan et al. (J: 247 Caucasian subjects aged 10-20 years) and our own data (O: 175 Asian subjects aged 6-20 years), and the results were compared between the two references. In this study, the mean age of the study population derived from each article was designated the representative age for transformation. Results: In either reference (J) or (O), there was no significant sex difference in CIMT at any given age. The mean CIMT of (Ab) and (Zs) transformed by (J) or (O) were significantly different between patients after KD and controls, at 41.6% (Ab), 66.6% (Zs) by (J), and 83.3% (Zs) by (O) among 12 articles, respectively. Therefore, patients after KD had significantly higher (Zs) by (O) than those of controls (0.66±0.71 vs. 0.03±0.68, p=0.006, respectively). Compared with reference values, the controls of (O) were within the normal range. However, there were no significant differences in (Zs) by (J) between the two groups (1.72±0.77 vs. 1.23±0.83, p=0.116, respectively). When we assessed 9 articles dealing with Asian subjects, the difference of (Zs) between the two groups remained significant only by (O) (p=0.015). In contrast, when we assessed 3 articles dealing with mainly Caucasian subjects, there was no significant difference in (Zs) between the two groups with both (J) and (O). Conclusions: These results indicate that age and race-specific reference values for CIMT are mandatory for performing an accurate assessment of the vascular status in healthy children and adolescents and particularly in those after KD.

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Longitudinal Systolic Left Ventricular Function in Preterm and Term Neonates: Reference Values of the Mitral Annular Plane Systolic Excursion (MAPSE) and Calculation of z-Scores

Pediatric Cardiology ◽

10.1007/s00246-014-0959-6 ◽

2014 ◽

Vol 36 (1) ◽

pp. 20-26 ◽

Cited By ~ 9

Author(s):

Martin Koestenberger ◽

Bert Nagel ◽

William Ravekes ◽

Andreas Gamillscheg ◽

Corinna Binder ◽

...

Keyword(s):

Left Ventricular Function ◽

Ventricular Function ◽

Reference Values ◽

Left Ventricular ◽

Term Neonates ◽

Systolic Left Ventricular Function ◽

Z Scores

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Reference Values for Aerobic Fitness in Children, Adolescents, and Young Adults Who Have Cerebral Palsy and Are Ambulatory

Physical Therapy ◽

10.2522/ptj.20090318 ◽

2010 ◽

Vol 90 (8) ◽

pp. 1148-1156 ◽

Cited By ~ 28

Author(s):

Olaf Verschuren ◽

Manon Bloemen ◽

Cas Kruitwagen ◽

Tim Takken

Keyword(s):

Young Adults ◽

Cerebral Palsy ◽

Young People ◽

Reference Values ◽

Aerobic Fitness ◽

Adolescents And Young Adults ◽

Cross Sectional ◽

Level I ◽

Shuttle Run ◽

Gmfcs Level

BackgroundVery few objective data exist regarding aerobic performance in young people with cerebral palsy (CP). The characterization of aerobic fitness could provide baseline and outcome measures for the rehabilitation of young people with CP.ObjectiveThe objective of this study was to provide reference values for aerobic fitness in a group of children, adolescents, and young adults who had CP and who were classified at Gross Motor Function Classification System (GMFCS) level I or II. Data were collected with 10-m shuttle run tests.DesignThis investigation was a cross-sectional observational study conducted between August 2008 and June 2009.MethodsReference values were established using data from a total of 306 children, adolescents, and young adults who had CP, who were 6 to 20 years old, and who were recruited from 26 rehabilitation centers in the Netherlands, Switzerland, Australia, Canada, and the United States. A total of 211 participants were classified at GMFCS level I (mean age=12.2 years, SD=3.0), and 95 were classified at GMFCS level II (mean age=12.4 years, SD=3.2); 181 were male, and 125 were female. Aerobic fitness was reflected by the level achieved on the 10-m shuttle run tests.ResultsOn the basis of a total of 306 assessments from the 10-m shuttle run tests, 4 reference curves were created.LimitationsThe limitation of this study is the cross-sectional nature of the design.ConclusionsThis study provided height-related reference values for aerobic fitness in children, adolescents, and young adults who had CP, who were 6 to 20 years old, and who were classified at GMFCS level I or II. Generalized additive models for location, scale, and shape were used to construct centile curves. These curves are clinically relevant and provide a user-friendly method for the prediction of aerobic fitness in young people with CP.

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