Background: In Tunisia, there are no normal values of pulmonary function for healthy Tunisian children. Objectives: The purpose of this study was to set reference values for spirometric lung function in Tunisian children and to compare these results with other data sets. Methods: Spirometric values were measured with a Minato portable spirometer in 1,114 asymptomatic, nonsmoking Tunisian children (581 boys and 533 girls) 6–16 years of age. Natural logarithmic values of lung function and standing height were used in the final regression model. Results: Prediction equations for forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC × 100, maximum mid expiratory flow (MMEF 25–75%) and peak expiratory flow (PEF) for both sexes are presented with standing height as the dependent variable. Our data show a significant increase in lung function with standing height in both sexes. Comparing our results with recent data, values of FVC and FEV1 in both sexes in the present study are close to those in European, white US and Asian children, whereas our values are higher than the Libyan ones. Conclusions: Healthy Tunisian children showed similar spirometric reference values compared to European, white US and Asian children. Thus, these standards of lung function could also be used in Tunisia.

Khaldi E, Joulak M, Jawahdou F: Infant asthma in Tunisia. Pediatr Pulmonol Suppl 1999;18:216–219.
Stewart AW, Mitchell EA, Pearce N, Stranchan DP, Weilandon SK: The relationship of per capita gross national product to the prevalence of symptoms of asthma and other atopic diseases in children (ISAAC). Int J Epidemiol 2001;30:173–179.
Gherghe S, Nanulescu MV, Panta-Chereches P, Popa M: The prevalence of bronchial asthma in 13- to 14-year-old schoolchildren in the city of Bistrita (in Romanian). Pneumologia 2000;49:95–99.
Vijayan VK, Reetha AM, Kuppurao KV, Venkatesan P, Thilakavathy S: Pulmonary function in normal south Indian children aged 7 to 19 years. Indian J Chest Dis Allied Sci 2000;42:147–156.
Tabka Z, Hassayoune H, Guenard H, Zebidi A, Commenges D, Essabah H, Salamon R, Varene P: Valeurs de référence spirométriques chez la population tunisienne. Tunis Med 1995;73:125–131.
Shaffer BA, Samet JM, Coultas DB, Stidley CA: Prediction of lung function in Hispanics using local ethnic-specific and external non-ethnic-specific prediction equations. Am Rev Respir Dis 1993;147:1349–1353.
Connett GJ, Quak SH, Wong ML, Teo J, Lee BW: Lung function reference values in Singaporean children aged 6–18 years. Thorax 1994;49:901–905.
Asher MI, Douglas C, Stewart AW, Quinn JP, Hill PM: Lung volumes in Polynesian children. Am Rev Respir Dis 1987;136:1360–1365.
Rosenthal M, Bain SH, Cramer D, Helms P, Denison D, Bush A, Warner JO: Lung function in white children aged 4 to 19 years. I. Spirometry. Thorax 1993;48:794–802.
Hankinson JL, Odencrantz JR, Fedan KB: Spirometric reference values from a sample of the general U.S. population. Am J Respir Crit Care Med 1999;159:179–187.
Boskabady MH, Keshmiri M, Banihashemi B, Anvary K: Lung function values in healthy non-smoking urban adults in Iran. Respiration 2002;69:320–326.
Shamssain MH, Thompson J, Ogston SA: Forced expiratory indices in normal Libyan children aged 6–19 years. Thorax 1988;43:467–470.
Ip MS, Karlberg EM, Karlberg JP, Luk KD, Leong JC: Lung function reference values in Chinese children and adolescents in Hong Kong. I. Spirometric values and comparison with other populations. Am J Respir Crit Care Med 2000;162:424–429.
Ferris BG: Epidemiology Standardisation Project. II. Recommended respiratory disease questionnaire for use with adults and children in epidemiological research. Am Rev Respir Dis 1978;118:7–53.
Kunzli N, Ackermann-Liebrich U, Keller R, Perruchoud AP, Schindler C: Variability of FVC and FEV1 due to technician, team, device and subject in an eight centre study: Three quality control studies in SAPALDIA. Swiss Study on Air Pollution and Lung Disease in Adults. Eur Respir J 1995;8:371–376.
Standardization of Spirometry, 1994 Update. American Thoracic Society. Am J Respir Crit Care Med 1995;152:1107–1136.
Altman DG, Gore SM, Gardner MJ: Statistical guidelines for contributors to medical journals. Br Med J (Clin Res Ed) 1983;286:1489–1493.
Greenough A, Hird M F, Everett L, Price JF: Importance of using lung function regression equation appropriate for ethnic origin. Pediatr Pulmonol 1991;12:5–13.
Leung SSF, Lau JTF, Xu YY, Tse LY, Huen KF, Wong GWK, Law WY, Yeung VTF, Yeung WKY, Leung NK: Secular changes in standing height, sitting height and sexual maturation of Chinese – the Hong Kong Growth Study, 1993. Ann Hum Biol 1993;23:297–306.
Shamssain MH: Forced expiratory indices in normal black southern African children aged 6–19 years. Thorax 1991;46:175–179.
Schrader PC, Quanjer PH, Van Zomeran BC, Wise ME: Changes in the FEV1-height relationship during pubertal growth. Bull Eur Physiopathol Respir 1984;20:381–388.
DeGroodt EG, Van Pelt W, Borsboom GJJM, Quanjer PH: Growth of lung and thorax dimensions during the pubertal growth spurt. Eur Respir J 1989;1:102–108.
Roca J, Sanchis J, Agusti-Vidal A: Spirometric reference values for a Mediterranean population. Bull Eur Physiopathol Respir 1986;22:217–224.
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