Factors affecting exhaled nitric oxide measurements: the effect of sex

Exhaled nitric oxide (F(E)NO) measurements are used as a surrogate marker for eosinophilic airway inflammation. However, many constitutional and environmental factors affect F(E)NO, making it difficult to devise reference values. Our aim was to evaluate the relative importance of factors affecting F...

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Bibliographic Details
Published in:	Respiratory research Vol. 8; no. 1; p. 82
Main Authors:	Taylor, D Robin, Mandhane, Piush, Greene, Justina M, Hancox, Robert J, Filsell, Sue, McLachlan, Christene R, Williamson, Avis J, Cowan, Jan O, Smith, Andrew D, Sears, Malcolm R
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 15-11-2007 BioMed Central BMC
Subjects:	Adult Asthma Breath Tests - methods Cohort Studies Diagnosis Exhalation - physiology Female Humans Male Measurement Nitric oxide Nitric Oxide - analysis Nitric Oxide - physiology Research Design Respiratory tract diseases Sex Characteristics New Zealand
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Summary:	Exhaled nitric oxide (F(E)NO) measurements are used as a surrogate marker for eosinophilic airway inflammation. However, many constitutional and environmental factors affect F(E)NO, making it difficult to devise reference values. Our aim was to evaluate the relative importance of factors affecting F(E)NO in a well characterised adult population. Data were obtained from 895 members of the Dunedin Multidisciplinary Health and Development Study at age 32. The effects of sex, height, weight, lung function indices, smoking, atopy, asthma and rhinitis on F(E)NO were explored by unadjusted and adjusted linear regression analyses. The effect of sex on F(E)NO was both statistically and clinically significant, with F(E)NO levels approximately 25% less in females. Overall, current smoking reduced F(E)NO up to 50%, but this effect occurred predominantly in those who smoked on the day of the F(E)NO measurement. Atopy increased F(E)NO by 60%. The sex-related differences in F(E)NO remained significant (p < 0.001) after controlling for all other significant factors affecting F(E)NO. Even after adjustment, F(E)NO values are significantly different in males and females. The derivation of reference values and the interpretation of FENO in the clinical setting should be stratified by sex. Other common factors such as current smoking and atopy also require to be taken into account.
ISSN:	1465-993X 1465-9921 1465-993X
DOI:	10.1186/1465-9921-8-82