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Reference ranges and determinant factors for exhaled nitric oxide in a healthy korean elderly population.

Jo EJ, Song WJ, Kim TW, Park HW, Chang YS, Kim TB, Kim SH, Hur GY, Lee JH, Yoon HJ, Park HS, Cho NH, Moon HB, Min KU, Cho SH - Allergy Asthma Immunol Res (2014)

Bottom Line: A total of 570 healthy subjects were analyzed (mean age, 59.9±12.3; male, 37.0%) for reference levels.FeNO levels significantly correlated with weight, height, body mass index, atopy, or forced expiratory volume in 1 second % predicted by simple linear regression analysis.Multiple linear regression analysis identified gender as an independent determinant for FeNO levels; subsequently, the reference values for FeNO were 18.2±10.6 ppb (5th to 95th percentile, 6.0 to 37.4 ppb) for males and 12.1±6.9 ppb (5th to 95th percentile, 2.5 to 27.0 ppb) for females.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.

ABSTRACT

Purpose: Exhaled nitric oxide (NO) is a useful non-invasive biomarker for asthma diagnosis; however, the literature suggests that exhaled NO levels may be affected by demographic factors. The present analysis investigated determinant factors that present exhaled NO reference levels for Korean elderly adults.

Methods: For reference levels, we analyzed the baseline data of healthy adult participants in the Ansung cohort. The fraction of exhaled NO (FeNO) was measured by NIOX MINO®. The characterization of the subjects was performed through structured questionnaires, spirometry, and methacholine challenge tests. To validate the diagnostic utility of the determined reference levels, asthma patients were recruited from medical institutions for FeNO measurement.

Results: A total of 570 healthy subjects were analyzed (mean age, 59.9±12.3; male, 37.0%) for reference levels. FeNO levels significantly correlated with weight, height, body mass index, atopy, or forced expiratory volume in 1 second % predicted by simple linear regression analysis. Multiple linear regression analysis identified gender as an independent determinant for FeNO levels; subsequently, the reference values for FeNO were 18.2±10.6 ppb (5th to 95th percentile, 6.0 to 37.4 ppb) for males and 12.1±6.9 ppb (5th to 95th percentile, 2.5 to 27.0 ppb) for females. The diagnostic utility of FeNO reference levels was validated by receiver operating curve analysis (area under curve, 0.900 for males and 0.885 for females) for diagnosing asthma. The optimal cutoff values for the prediction of asthma were 30.5 ppb for males and 20.5 ppb for females.

Conclusions: The current analysis presented reference ranges and the diagnostic utility of FeNO levels for asthma in Korean elderly adults.

No MeSH data available.


Related in: MedlinePlus

Receiver-operator characteristic (ROC) analysis of the fraction of exhaled nitric oxide (FeNO). (A) ROC curve of FeNO for males (n=241). (B) ROC curve of FeNO for females (n=403).
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Figure 2: Receiver-operator characteristic (ROC) analysis of the fraction of exhaled nitric oxide (FeNO). (A) ROC curve of FeNO for males (n=241). (B) ROC curve of FeNO for females (n=403).

Mentions: We compared the distribution of FeNO levels in asthma patients and healthy population to validate the utility of FeNO (Fig. 1); subsequently, the ROC curves were constructed from the combined group of 570 healthy population and 74 asthma patients (mean age, 54.4±16.8; male, 40.5%; Table 5). The area under the ROC curve was 0.900 in males and 0.885 in females (Fig. 2). The sensitivity and specificity of FeNo measurement was 60% and 95.3% respectively in males 65.9% and 95.3% in females when the cutoff value of FeNO for the prediction of asthma was provided from the upper limit of 90% CI (37.4 ppb for males and 27.0 ppb for females) (Table 6). The cutoff value from the best combination of sensitivity and specificity was 30.5 ppb in males and 20.5 ppb in females; this indicated a sensitivity of 70.0% and a specificity of 90.0% in males, a sensitivity of 79.5% and a specificity of 86.9% in females (Table 6).


Reference ranges and determinant factors for exhaled nitric oxide in a healthy korean elderly population.

Jo EJ, Song WJ, Kim TW, Park HW, Chang YS, Kim TB, Kim SH, Hur GY, Lee JH, Yoon HJ, Park HS, Cho NH, Moon HB, Min KU, Cho SH - Allergy Asthma Immunol Res (2014)

Receiver-operator characteristic (ROC) analysis of the fraction of exhaled nitric oxide (FeNO). (A) ROC curve of FeNO for males (n=241). (B) ROC curve of FeNO for females (n=403).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4214970&req=5

Figure 2: Receiver-operator characteristic (ROC) analysis of the fraction of exhaled nitric oxide (FeNO). (A) ROC curve of FeNO for males (n=241). (B) ROC curve of FeNO for females (n=403).
Mentions: We compared the distribution of FeNO levels in asthma patients and healthy population to validate the utility of FeNO (Fig. 1); subsequently, the ROC curves were constructed from the combined group of 570 healthy population and 74 asthma patients (mean age, 54.4±16.8; male, 40.5%; Table 5). The area under the ROC curve was 0.900 in males and 0.885 in females (Fig. 2). The sensitivity and specificity of FeNo measurement was 60% and 95.3% respectively in males 65.9% and 95.3% in females when the cutoff value of FeNO for the prediction of asthma was provided from the upper limit of 90% CI (37.4 ppb for males and 27.0 ppb for females) (Table 6). The cutoff value from the best combination of sensitivity and specificity was 30.5 ppb in males and 20.5 ppb in females; this indicated a sensitivity of 70.0% and a specificity of 90.0% in males, a sensitivity of 79.5% and a specificity of 86.9% in females (Table 6).

Bottom Line: A total of 570 healthy subjects were analyzed (mean age, 59.9±12.3; male, 37.0%) for reference levels.FeNO levels significantly correlated with weight, height, body mass index, atopy, or forced expiratory volume in 1 second % predicted by simple linear regression analysis.Multiple linear regression analysis identified gender as an independent determinant for FeNO levels; subsequently, the reference values for FeNO were 18.2±10.6 ppb (5th to 95th percentile, 6.0 to 37.4 ppb) for males and 12.1±6.9 ppb (5th to 95th percentile, 2.5 to 27.0 ppb) for females.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.

ABSTRACT

Purpose: Exhaled nitric oxide (NO) is a useful non-invasive biomarker for asthma diagnosis; however, the literature suggests that exhaled NO levels may be affected by demographic factors. The present analysis investigated determinant factors that present exhaled NO reference levels for Korean elderly adults.

Methods: For reference levels, we analyzed the baseline data of healthy adult participants in the Ansung cohort. The fraction of exhaled NO (FeNO) was measured by NIOX MINO®. The characterization of the subjects was performed through structured questionnaires, spirometry, and methacholine challenge tests. To validate the diagnostic utility of the determined reference levels, asthma patients were recruited from medical institutions for FeNO measurement.

Results: A total of 570 healthy subjects were analyzed (mean age, 59.9±12.3; male, 37.0%) for reference levels. FeNO levels significantly correlated with weight, height, body mass index, atopy, or forced expiratory volume in 1 second % predicted by simple linear regression analysis. Multiple linear regression analysis identified gender as an independent determinant for FeNO levels; subsequently, the reference values for FeNO were 18.2±10.6 ppb (5th to 95th percentile, 6.0 to 37.4 ppb) for males and 12.1±6.9 ppb (5th to 95th percentile, 2.5 to 27.0 ppb) for females. The diagnostic utility of FeNO reference levels was validated by receiver operating curve analysis (area under curve, 0.900 for males and 0.885 for females) for diagnosing asthma. The optimal cutoff values for the prediction of asthma were 30.5 ppb for males and 20.5 ppb for females.

Conclusions: The current analysis presented reference ranges and the diagnostic utility of FeNO levels for asthma in Korean elderly adults.

No MeSH data available.


Related in: MedlinePlus