Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA.
Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA; Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA.
Respir Med. 2018 Dec;145:212-216. doi: 10.1016/j.rmed.2018.11.005. Epub 2018 Nov 10.
Asthma prevalence continues to increase in low and middle-income countries, presenting challenges in assessing asthma control in resource-poor settings. Previous studies suggest that exhaled carbon monoxide (eCO) is higher with asthma severity and lower with treatment. We hypothesized that eCO levels may be elevated in children with asthma, particularly in children with partially controlled or uncontrolled asthma in a low-resource setting in Lima, Peru.
We compared average eCO levels between 248 children with asthma and 221 healthy controls as well as the odds of asthma by eCO quartiles (0-1, 2, 3, and ≥4 ppm) using multivariable linear and logistic regression. eCO quartiles were also used to compare the odds of partially controlled or uncontrolled asthma (score ≤19 on the Asthma Control Test) in a multivariable logistic regression model.
Average adjusted eCO level was 0.56 ppm (95% CI 0.07-1.05) higher in children with asthma. The adjusted odds of asthma were 1.22 (95% CI 0.75-1.97), 1.46 (0.81-2.63), and 1.76 (0.96-3.23) in the second, third, and fourth eCO quartiles compared to the first eCO quartile, respectively. Among children with asthma, the adjusted odds of partially controlled or uncontrolled asthma in those in the second, third, and fourth eCO quartiles, compared to the first, were 1.61 (95% CI 0.74-3.48), 3.66 (95% CI 1.51-8.87), and 2.50 (95% CI 1.06-5.90), respectively.
eCO may serve as an inexpensive biomarker for asthma control, particularly in low-resource settings.
哮喘在中低收入国家的发病率持续上升，这给资源匮乏环境下评估哮喘控制情况带来了挑战。既往研究表明，呼出气一氧化碳（eCO）水平与哮喘严重程度呈正相关，与治疗效果呈负相关。我们假设在秘鲁利马的资源匮乏环境中，哮喘儿童的 eCO 水平可能升高，尤其是部分控制或未控制哮喘的儿童。
我们对比了 248 名哮喘儿童和 221 名健康对照者的平均 eCO 水平，同时使用多变量线性和逻辑回归分析了 eCO 四分位数（0-1、2、3 和≥4ppm）与哮喘的比值比（OR）。我们还在多变量逻辑回归模型中比较了 eCO 四分位数与部分控制或未控制哮喘（哮喘控制测试评分≤19）的比值比。
哮喘儿童的平均校正 eCO 水平高 0.56ppm（95%CI 0.07-1.05）。与 eCO 四分位第 1 位相比，第 2、3 和 4 位的哮喘 OR 分别为 1.22（95%CI 0.75-1.97）、1.46（95%CI 0.81-2.63）和 1.76（95%CI 0.96-3.23）。在哮喘儿童中，与 eCO 四分位第 1 位相比，第 2、3 和 4 位的部分控制或未控制哮喘的 OR 分别为 1.61（95%CI 0.74-3.48）、3.66（95%CI 1.51-8.87）和 2.50（95%CI 1.06-5.90）。
eCO 可能成为评估哮喘控制情况的一种廉价生物标志物，尤其是在资源匮乏的环境中。
