open access

Vol 85, No 4 (2017)
ORIGINAL PAPERS
Published online: 2017-08-28
Submitted: 2017-06-30
Accepted: 2017-08-07
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Exhaled nitric oxide atopy, and spirometry in asthma and rhinitis patients in India

Raj Kumar, Nitesh Gupta
DOI: 10.5603/ARM.2017.0031
·
Adv Respir Med 2017;85(4):186-192.

open access

Vol 85, No 4 (2017)
ORIGINAL PAPERS
Published online: 2017-08-28
Submitted: 2017-06-30
Accepted: 2017-08-07

Abstract

INTRODUCTION: Asthma is a chronic airway inflammatory disorder. Nitric oxide (NO) is non-invasively measured in exhaled breath (FeNO). The aim of the study was to investigate the anthropometric and physiologic factors that influence FeNO measurements. Also, to evaluate FeNO correlation with spirometry and inflammatory markers in asthma and rhinitis.

MATERIAL AND METHODS: The study was a prospective analysis of asthma (BA) and rhinitis (AR) in patients enrolled from outpatient clinics between 2011 and 2015. Healthy controls (HC) were enrolled from the community. All subjects underwent baseline spirometry with reversibility, FeNO measurements, skin prick tests, and blood sampling for absolute eosinophil counts and serum total IgE levels.

RESULTS: Of 528 enrolled participants, 215 were BA, 248 were BA-AR and 65 were HC. The mean FeNO was higher in atopic versus nonatopic subjects (34.14 vs. 25.99; p < 0.001); asthmatics versus non-asthmatics (30.46 vs. 12.91; p < 0.001), and in participants with BA-AR, compared to those without BA-AR (32.56 vs. 30.46; p < 0.001). The odds ratio for FeNO in the study population showed a significant positive association with male gender, absolute eosinophil count (AEC), breathlessness, duration of symptoms, family history and atopy. In examining the diagnostic accuracy of FeNO for asthma, the AUC for FeNO value is 0.833 (95% confidence interval [CI], 0.717–0.901), with cut-off levels to screen for asthma being 19.45 at 71.2% sensitivity and 81.8% specificity (p < 0.001). The Positive Predictive Value 96.84% (95% CI: 94.43–98.23) and Negative Predictive Value 30% (95% CI: 23.78–37.05) for asthma prediction with FeNO.

CONCLUSION: The study highlights the importance of estimation of anthropometric parameters and dyspnea assessment in the evaluation of FeNO levels. Also, the presence of atopy may influence the results in the interpretation of FeNO readings. Moreover, the study have demonstrated that spirometry and FeNO have no significant correlation, which further lays emphasis on them as being different physiological parameters of asthma.

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Abstract

INTRODUCTION: Asthma is a chronic airway inflammatory disorder. Nitric oxide (NO) is non-invasively measured in exhaled breath (FeNO). The aim of the study was to investigate the anthropometric and physiologic factors that influence FeNO measurements. Also, to evaluate FeNO correlation with spirometry and inflammatory markers in asthma and rhinitis.

MATERIAL AND METHODS: The study was a prospective analysis of asthma (BA) and rhinitis (AR) in patients enrolled from outpatient clinics between 2011 and 2015. Healthy controls (HC) were enrolled from the community. All subjects underwent baseline spirometry with reversibility, FeNO measurements, skin prick tests, and blood sampling for absolute eosinophil counts and serum total IgE levels.

RESULTS: Of 528 enrolled participants, 215 were BA, 248 were BA-AR and 65 were HC. The mean FeNO was higher in atopic versus nonatopic subjects (34.14 vs. 25.99; p < 0.001); asthmatics versus non-asthmatics (30.46 vs. 12.91; p < 0.001), and in participants with BA-AR, compared to those without BA-AR (32.56 vs. 30.46; p < 0.001). The odds ratio for FeNO in the study population showed a significant positive association with male gender, absolute eosinophil count (AEC), breathlessness, duration of symptoms, family history and atopy. In examining the diagnostic accuracy of FeNO for asthma, the AUC for FeNO value is 0.833 (95% confidence interval [CI], 0.717–0.901), with cut-off levels to screen for asthma being 19.45 at 71.2% sensitivity and 81.8% specificity (p < 0.001). The Positive Predictive Value 96.84% (95% CI: 94.43–98.23) and Negative Predictive Value 30% (95% CI: 23.78–37.05) for asthma prediction with FeNO.

CONCLUSION: The study highlights the importance of estimation of anthropometric parameters and dyspnea assessment in the evaluation of FeNO levels. Also, the presence of atopy may influence the results in the interpretation of FeNO readings. Moreover, the study have demonstrated that spirometry and FeNO have no significant correlation, which further lays emphasis on them as being different physiological parameters of asthma.

&nbsp;

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Keywords

asthma, rhinitis, atopy, FeNO

About this article
Title

Exhaled nitric oxide atopy, and spirometry in asthma and rhinitis patients in India

Journal

Advances in Respiratory Medicine

Issue

Vol 85, No 4 (2017)

Pages

186-192

Published online

2017-08-28

DOI

10.5603/ARM.2017.0031

Bibliographic record

Adv Respir Med 2017;85(4):186-192.

Keywords

asthma
rhinitis
atopy
FeNO

Authors

Raj Kumar
Nitesh Gupta

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