Yamada Mitsuhiro, Takase Masato, Nakaya Kumi, Nakamura Tomohiro, Kogure Mana, Nakaya Naoki, Fujino Naoya, Tamada Tsutomu, Iwasaki Chikashi, Suzuki Manami, Matsumoto Shuichiro, Fuse Nobuo, Uruno Akira, Kumada Kazuki, Ogishima Soichi, Kuriyama Shinichi, Ichinose Masakazu, Sugiura Hisatoshi, Hozawa Atsushi
Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.
J Allergy Clin Immunol Glob. 2024 Apr 8;3(3):100253. doi: 10.1016/j.jacig.2024.100253. eCollection 2024 Aug.
Measurement of fractional exhaled nitric oxide (Feno) has been used in the diagnosis and management of asthma. Understanding the distribution of Feno in a larger resident population and its "healthy" subpopulation would contribute to the interpretation of Feno in clinical practice.
This study aimed to investigate the distribution and its associated factors in the adult population and its healthy subpopulations.
We conducted a cross-sectional study of 8,638 men and 17,288 women aged 20 years or older living in Miyagi prefecture, Japan. We investigated the distribution of Feno and its associated factors in all subjects, a subpopulation with no history of upper and lower airway diseases (healthy subpopulation 1), and a subpopulation with no history of upper and lower airway diseases, normal lung function, and no positivity for other biomarkers of type 2 inflammation (healthy subpopulation 2).
The distribution of Feno in healthy subpopulations, especially in healthy subpopulation 2 (median [interquartile range], 17 [12-23] with 95th percentile of 36 ppb) was lower than in all subjects (19 [13-26] ppb with 95th percentile of 47 ppb). In healthy subpopulation 1, 10.3% had elevated Feno (≥35 ppb), and elevated Feno was positively associated with factors including obstructive ventilatory defect, blood eosinophilia, house dust mite-specific IgE positivity, and history of hypertension. Male sex was associated with elevated Feno in all subjects and healthy subpopulations.
The distribution of Feno in the healthy subpopulation supports the validity of the criteria (≥35 ppb) currently used in Japan for the diagnosis of asthma.
呼出一氧化氮分数（Feno）的测量已用于哮喘的诊断和管理。了解Feno在更大规模居民群体及其“健康”亚群体中的分布，将有助于在临床实践中对Feno进行解读。
本研究旨在调查成年人群体及其健康亚群体中Feno的分布及其相关因素。
我们对居住在日本宫城县的8638名20岁及以上男性和17288名20岁及以上女性进行了横断面研究。我们调查了所有受试者、无上、下气道疾病病史的亚群体（健康亚群体1）以及无上、下气道疾病病史、肺功能正常且无其他2型炎症生物标志物阳性的亚群体（健康亚群体2）中Feno的分布及其相关因素。
健康亚群体中Feno的分布，尤其是健康亚群体2（中位数[四分位间距]，17[12 - 23]，第95百分位数为36 ppb）低于所有受试者（19[13 - 26] ppb，第95百分位数为47 ppb）。在健康亚群体1中，10.3%的人Feno升高（≥35 ppb），Feno升高与阻塞性通气功能障碍、血液嗜酸性粒细胞增多、屋尘螨特异性IgE阳性以及高血压病史等因素呈正相关。在所有受试者和健康亚群体中，男性与Feno升高有关。
健康亚群体中Feno的分布支持了日本目前用于哮喘诊断的标准（≥35 ppb）的有效性。
