Conreference values and determinants of fractional concentration of exhaled nitric oxide in healthy children

Hyun Ju Cho, Young Ho Jung, Song I. Yang, Eun Lee, Hyung Young Kim, Ju Hee Seo, Ji Won Kwon, Byoung Ju Kim, Hyo Bin Kim, So Yeon Lee, Dae Jin Song, Woo Kyung Kim, Gwang Cheon Jang, Jung Yeon Shim, Soo Jong Hong

    Research output: Contribution to journalArticlepeer-review

    14 Citations (Scopus)

    Abstract

    Purpose: Measurement of the fractional concentration of exhaled nitric oxide (FeNO) is a quantitative, noninvasive, simple, safe method of assessing airway inflammation. While FeNO measurement has been standardized, reference values for elementary school children are scarce. The aim of this study was to establish reference values for FeNO in children. Methods: FeNO was measured in elementary school children at 6-12 years of age in Seoul, Korea, following American Thoracic Society guidelines and using a chemiluminescence analyzer (NIOX Exhaled Nitric Oxide Monitoring System, Aerocrine, Sweden). A total of 1,252 children completed a modified International Study of Asthma and Allergy in Children (ISAAC) questionnaire; FeNO was measured in 1,063 children according to the protocol and in 808 children defined as healthy controls. Results: Mean FeNO were 10.32 ppb, 16.58 ppb, and 12.36 ppb in non-atopic, atopic, and all 808 healthy controls, respectively. FeNO was not associated with age and gender. The FeNO reference equations were determined by multiple linear regression analysis, taking into account the variables of age, height, weight, total IgE, eosinophil percent, and bronchial hyper-responsiveness (methacholine PC20). FeNO=0.776+0.003×total IgE+0.340×eosinophil percent; coefficient of determination (R22)=0.084 in the 501 healthy non-atopic controls. FeNO=-18.365+1.536×eosinophil percent, R2=0.183 in the 307 healthy atopic controls; and FeNO=-7.888+0.130×Height+0.004×total IgE+1.233×eosinophil percent, R2=0.209 in the 808 all healthy controls. Eosinophil percent was correlated with FeNO in all healthy controls. FeNO was not associated with BMI. Conclusion: This study provides reference values for FeNO that can be used to evaluate airway inflammation in elementary school children. Determinants that could most accurately predict FeNO in healthy school-age children were assessed.

    Original languageEnglish
    Pages (from-to)169-174
    Number of pages6
    JournalAllergy, Asthma and Immunology Research
    Volume6
    Issue number2
    DOIs
    Publication statusPublished - 2014 Mar

    Keywords

    • FeNO
    • children
    • determinants
    • healthy
    • reference value

    ASJC Scopus subject areas

    • Immunology and Allergy
    • Immunology
    • Pulmonary and Respiratory Medicine

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