Sex differences in concentrations of exhaled nitric oxide and plasma nitrate

Jilma, Bernd; Kästner, Johannes; Mensik, Christa; Vondrovec, Barbara; Hildebrandt, Jörg; Krejcy, Kurt; Wagner, Oswald; Eichler, Hans‐Georg

doi:10.1016/0024-3205(95)02311-9

Cited by 105 publications

(47 citation statements)

References 29 publications

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“…A sex difference in orally exhaled air, with lower levels of NO in females, supports the findings in at least two previous studies [25,26] and may be due to dietary or metabolic factors. That the difference between males and females is related to sex, and not to height and weight, is supported by the finding that there was no correlation between body surface area and oral or nasally exhaled NO, suggesting a nonlinear relationship between body surface area and exhaled NO levels.…”

Section: Discussionsupporting

confidence: 88%

Characterization of exhaled nitric oxide: introducing a new reproducible method for nasal nitric oxide measurements

Palm¹,

Gräf

Lundberg³

et al. 2000

Eur Respir J

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Nitric oxide (NO) is present in the human nasal airways and has been suggested to originate primarily from the paranasal sinuses. The aim of this study was to establish a new and reproducible method for measurement of nasal NO.Through repeated single-breath measurements the intra-and inter-individual variations of NO levels in nasally (into a tightly fitting mask covering the nose) and orally exhaled air were determined in healthy humans. Variations due to the methods used were investigated. The contribution of oral NO to the nasal exhalations by introducing a mouthwash procedure was also studied.This study shows distinct individual values of NO in nasally and orally exhaled air of healthy humans. Some diurnal variability was also found with a rise in NO in nasally and orally exhaled air over the day, but no, or little, day-to-day variability when comparing the results from separate mornings. There was no correlation between NO levels in nasally and orally exhaled air, whereas there was a strong correlation between NO levels in air exhaled through the left and right nostril. The levels of NO in air exhaled at 0.17 L . s -1 through either nostril separately were higher than in air exhaled at the same flow rate through both nostrils simultaneously. After the introduction of a mouthwash procedure the level of NO in orally, but not nasally exhaled air was reduced.To conclude the method using nasal exhalation into a nose mask is highly reproducible. It is also suggested that subtracting the level of NO in orally exhaled air, after mouthwash, from that in nasally exhaled air, would adequately reflect nasal NO levels. Eur Respir J 2000; 16: 236±241.

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Section: Discussionsupporting

confidence: 88%

Characterization of exhaled nitric oxide: introducing a new reproducible method for nasal nitric oxide measurements

Palm¹,

Gräf

Lundberg³

et al. 2000

Eur Respir J

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“…9 In addition, these findings are compatible with those of Chowienczyk et al 3 and Kharatinov and colleagues. 4 However, our results differ from those of Jilma et al 5 and Takahashi and colleagues, 6 who reported that the plasma levels of nitrate were greater in men than in women. A confounding factor in the interpretation of their findings could be the contribution of nitrite and nitrate to the plasma pool from the diet.…”

Section: N Nitrate After Intravenous Administration Of L-[contrasting

confidence: 57%

“…2 Previous studies have suggested that a gender difference in the production of NO due to ovarian hormones (ie, estrogens) could contribute to this low risk of cardiovascular events in women of reproductive age. However, the role of NO is controversial because increased 3,4 or diminished 5,6 production in women compared with men has been reported. It is possible that the indirect nature and relative specificity of the methods used for the measurement of NO in those studies might account for these discrepancies.…”

mentioning

confidence: 99%

Evidence for a Difference in Nitric Oxide Biosynthesis Between Healthy Women and Men

et al. 1998

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Abstract-There is indirect evidence for a gender difference in nitric oxide (NO) synthesis from vascular endothelium. The aim of the present study was to determine NO production more directly in healthy women and men by the measurement of 15 N nitrate excreted in urine after the intravenous administration of L-[ 15 N] 2 -guanidino arginine. Twenty-four healthy volunteers (13 men aged 22 to 40 years and 11 women aged 23 to 42 years) participated in this study. No subjects were receiving any medication. Women were studied between the 7th and 14th days of their menstrual cycles. Arterial blood pressure was measured oscillometrically, and 1.13 mol L-[ 15 N] 2 arginine was administered intravenously after an overnight fast. Urine was collected for the next 36 hours in separate 12-hour periods. Urinary 15 N/ 14 N nitrate ratio was assessed by dry combustion in an isotope ratio mass spectrometer. Mean 36-hour urinary 15 N nitrate excretion was greater in women than in men (2111Ϯ139 versus 1682Ϯ87 mol; PϽ0.05). Furthermore, total urinary 15 N nitrate excretion was associated inversely with the mean arterial blood pressure in the whole group of subjects (coefficient of correlation, 0.47; Pϭ0.022). The present data show that whole-body production of NO is greater in healthy premenopausal women than in men under ambulatory conditions. The cellular origin of NO measured in this study is unknown, but differences in endothelial production could underlie differences in vascular function between men and women. (Hypertension. 1998;32:730-734.) Key Words: endothelium-derived relaxing factor Ⅲ arginine Ⅲ nitrates Ⅲ gender Ⅲ adults P remenopausal women have less atheromatous arterial disease, including stroke or coronary artery disease, than men of similar age.1 Synthesis of nitric oxide (NO) by the endothelium regulates vascular tone in the arterial bed and modulates interactions between the endothelium and circulating blood cells, including platelets and leukocytes.2 Previous studies have suggested that a gender difference in the production of NO due to ovarian hormones (ie, estrogens) could contribute to this low risk of cardiovascular events in women of reproductive age. However, the role of NO is controversial because increased 3,4 or diminished 5,6 production in women compared with men has been reported. It is possible that the indirect nature and relative specificity of the methods used for the measurement of NO in those studies might account for these discrepancies. Measurement of urinary or serum nitrate is highly affected by diet.7 Cyclic GMP is also the second messenger of atrial natriuretic peptide, 8 and exhaled NO reflects local biosynthesis in the lung and/or upper airways rather than in the whole body. We have developed a sensitive and specific method to measure more directly the conversion of L-arginine to NO. 9 The method is based on the measurement of 15 N nitrate (stable oxidation product of NO) excretion in urine after intravenous single administration of the stable isotope L-[ 15 N] 2 -guanidino arginine. Us...

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“…Only in one previous study was a difference in FENO between males and females found. However, in this study higher FENO levels as well as higher plasma nitrate levels were found in males [22]. Male and female children in the present study did not differ in weight, height or age.…”

Section: Discussioncontrasting

confidence: 38%

Exhaled nitric oxide measurements with dynamic flow restriction in children aged 4–8 yrs

Pijnenburg

Lissenberg²,

Hofhuis³

et al. 2002

Eur Respir J

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Fractional exhaled nitric oxide concentration (FENO) depends on exhalation flow; however, children often are unable to perform controlled flow procedures. Therefore, a device was developed for off-line FENO sampling, with dynamic flow restriction (DFR).The authors compared off-line with on-line FENO, assessed feasibility, and obtained normal values for FENO in children aged 4-8 yrs. Subjects inhaled nitric oxide (NO)-free air and exhaled into the device, where DFR kept exhalation flow constant at 50 mL?s -1 . Dead space air was discarded. Exhaled air was collected in a 150 mL mylar balloon. On-line measurements were performed and values compared with off-line FENO in 19 adult volunteers. Seventy-nine children performed off-line sampling. All samples were analysed with a chemiluminescence NO-analyser. Normal values were obtained in 34 healthy children.There was an excellent correlation between on-and off-line values. Bland and Altman plots showed good agreement between on-and off-line FENO. Seventy-four out of 79 children were able to perform a correct off-line procedure. Geometric mean¡SEM FENO in healthy children was 4.9 ¡ 1.2 parts per billion (ppb) for male children and 7.6 ¡ 1.1 ppb for female children.It can be concluded that off-line fraction of exhaled nitric oxide measurements with dynamic flow restriction are feasible in young children and correspond to on-line values. Eur Respir J 2002; 20: 919-924.

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Sex differences in concentrations of exhaled nitric oxide and plasma nitrate

Cited by 105 publications

References 29 publications

Characterization of exhaled nitric oxide: introducing a new reproducible method for nasal nitric oxide measurements

Characterization of exhaled nitric oxide: introducing a new reproducible method for nasal nitric oxide measurements

Evidence for a Difference in Nitric Oxide Biosynthesis Between Healthy Women and Men

Exhaled nitric oxide measurements with dynamic flow restriction in children aged 4–8 yrs

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