Nguyen Duong T, Kit Brian K, Brody Debra, Akinbami Lara J
Epidemic Intelligence Service, Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, Maryland.
Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland.
Pediatr Pulmonol. 2017 Jun;52(6):737-745. doi: 10.1002/ppul.23672.
High fractional exhaled nitric oxide (FeNO) is an indicator of poor asthma control and has been proposed as a non-invasive assessment tool to guide asthma management.
We aimed to describe the prevalence of and factors associated with high FeNO among US youth with asthma.
Data from 716 children and adolescents with asthma ages 6-19 years who participated in the 2007-2012 National Health and Nutrition Examination Survey were analyzed. Using American Thoracic Society guidelines, high FeNO was defined as >50 ppb for ages 12-19 years and >35 ppb for ages 6-11 years. Multivariate logistic regression examined associations between high FeNO and age, sex, race/Hispanic origin, income status, weight status, tobacco smoke exposure, and other factors associated with asthma control (recent use of inhaled corticosteroids, recent respiratory illness, asthma-related respiratory signs/symptoms, and spirometry).
About 16.5% of youth with asthma had high FeNO. The prevalence of high FeNO was higher among non-Hispanic black (27%, P < 0.001) and Hispanic (20.2%, P = 0.002) youth than non-Hispanic white (9.7%) youth. Differences in high FeNO prevalence by sex (girls < boys), weight status (obese < normal weight), tobacco smoke exposure (smokers < home exposure < no exposure), and FEV1/FVC (normal < abnormal) were also observed. No differences were noted between categories for the remaining covariates.
High FeNO was observed to be associated with sex, race/Hispanic origin, weight status, tobacco smoke exposure, and abnormal FEV1/FVC, but was not associated with asthma-related respiratory symptoms. These findings may help inform future research and clinical practice guidelines on the use of high FeNO in the assessment of asthma control.
呼出气一氧化氮分数（FeNO）升高是哮喘控制不佳的一个指标，并且已被提议作为指导哮喘管理的一种非侵入性评估工具。
我们旨在描述美国哮喘青少年中FeNO升高的患病率及其相关因素。
分析了参加2007 - 2012年国家健康与营养检查调查的716名6 - 19岁哮喘儿童和青少年的数据。根据美国胸科学会指南，12 - 19岁人群FeNO升高定义为>50 ppb，6 - 11岁人群定义为>35 ppb。多因素逻辑回归分析了FeNO升高与年龄、性别、种族/西班牙裔血统、收入状况、体重状况、烟草烟雾暴露以及其他与哮喘控制相关的因素（近期吸入糖皮质激素的使用、近期呼吸道疾病、哮喘相关的呼吸道体征/症状以及肺功能测定）之间的关联。
约16.5%的哮喘青少年FeNO升高。非西班牙裔黑人青少年（27%，P < 0.001）和西班牙裔青少年（20.2%，P = 0.002）中FeNO升高的患病率高于非西班牙裔白人青少年（9.7%）。在性别（女孩<男孩）、体重状况（肥胖<正常体重）、烟草烟雾暴露（吸烟者<家庭暴露<无暴露）以及FEV1/FVC（正常<异常）方面，FeNO升高的患病率也存在差异。其余协变量类别之间未观察到差异。
观察到FeNO升高与性别、种族/西班牙裔血统、体重状况、烟草烟雾暴露以及FEV1/FVC异常有关，但与哮喘相关的呼吸道症状无关。这些发现可能有助于为未来关于使用FeNO评估哮喘控制的研究和临床实践指南提供信息。
