Effects of age, gender, and environmental exposures on exhaled nitric oxide level in healthy 12 to 18 years Qatari children

Abstract

CONTEXT:Fractional exhaled nitric oxide (FENO) is a useful noninvasive diagnostic tool for asthma and some other pediatric respiratory diseases. Factors affecting FENO level are variable in different populations and studies.AIMS:To estimate the normal values of exhaled nitric oxide for Qataris 12 to 18 years of age. Other objectives were to measure the correlation of anthropometric and other potential factors with FENO levels.SETTINGS AND DESIGN:Community-based, cross-sectional study.METHODS:A total of 438 Qatari national school children from both genders were randomly recruited in cross-sectional study. Of them, 203 were non-atopic and hence included in the statistical analysis. Questionnaires including personal data, demographic data, and other factors that may affect FENO level were distributed.STATISTICAL ANALYSIS USED:Comparison of means done using t-test. We performed Spearman's rho test to measure correlations. Data analysis was done using PASW 18.0 Release 18.0.0, 2009.RESULTS:The geometric mean of FENO levels for all subjects was 14.1 ppb (upper level CI 95% - 36.3 ppb). FENO was significantly higher in males (R2 = −0.254, P<0.0001) and was negatively correlated with increasing age for the whole study population (P=0.036). This decline was interrupted by a significant upraise at the age of 15 years (P=0.0462) which seems to be driven by the males (P=0.0244). FENO levels were lower in subjects exposed to cats (P=0.019). We could not find significant correlation between FENO and other factors studied.CONCLUSIONS:Estimated FENO level with 95% CI in Qatari children, which is probably close to those in other Gulf countries, will be helpful clinically. The lower level of FENO with female gender, increasing age, and exposure to cats needs to be further studied to establish the association and to understand the underlying mechanisms.

Relationship between total serum immunoglobulin E levels, fractional exhaled breath nitric oxide levels and absolute blood eosinophil counts in atopic and non-atopic asthma: a controlled comparative study

“…F E NO levels are known to reduce with increasing age, with lowest levels seen in the elderly and highest peak observed in teenagers. The literature supports the notion of a gradual increase of F E NO during childhood development and adolescence with sustained levels during adult life which tends to increase after the sixth decade till the eighth [38,39]. There was no statistical correlation between age and level of F E NO in both asthma and non-asthma groups in our study.…”

Biomonitoring Environmental Exposure in Syrian Refugees in Lebanon

“…One of the clinical management guidelines for asymptomatic patients with high and intermediate levels of FeNO is to consider high baseline NO production and/or persistent allergen exposure potentially due to subclinical inflammation of lower airways with the absence of symptoms [ 32 , 42 , 43 ]. Additional confounding factors, such as gender, age, smoking, nutrition, cirrhosis, viruses, and bacterial infections, should also be taken into account when interpreting FeNO results [ 44 , 45 , 46 ]. Although other shelter types, such as residential shelters, were not assessed, as mentioned, the previous study revealed that non-residential shelters had the highest concentrations of mould, followed by non-permanent shelters [ 11 ].…”

“…Epidemiologia 2024, 5, FOR PEER REVIEW 7 nutrition, cirrhosis, viruses, and bacterial infections, should also be taken into account when interpreting FeNO results [44][45][46]. Although other shelter types, such as residential shelters, were not assessed, as mentioned, the previous study revealed that non-residential shelters had the highest concentrations of mould, followed by non-permanent shelters [11].…”

Successful Fractional Exhaled Nitric Oxide Measurements with NIOX VERO using 6- and 10-s Exhalation Modes in Children with Asthma Aged 4–10 Years: A Randomized Study

“…Other studies have also shown the feasibility of the 6-s mode in FeNO fractional exhaled nitric oxide children (aged 4-18 years) using the NIOX MINO Ò device [19][20][21][22][23]. This was a one-visit study simply designed in order to evaluate clinical validation of the NIOX VERO Ò device using the 6-s and 10-s modes in young children.…”