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Important non-disease-related determinants of exhaled nitric oxide levels in mild asthma - results from the Swedish GA(2)LEN study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
Karolinska Inst, Inst Environm Med, Expt Asthma & Allergy Res Unit, Stockholm, Sweden..
Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden..
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2016 (English)In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 46, no 9, 1185-1193 p.Article in journal (Refereed) Published
Abstract [en]

Background Fractional exhaled nitric oxide (FeNO) has a potential clinical role in asthma management. Constitutive factors such as age, height and gender, as well as individual characteristics, such as IgE sensitization and smoking, affect the levels of FeNO in population-based studies. However, their effect on FeNO in subjects with asthma has been scarcely studied. Objective To study the effects on FeNO of these commonly regarded determinants, as demonstrated in healthy subjects, as well as menarche age and parental smoking, in a population of asthmatics. Material and Methods Fractional exhaled nitric oxide was measured in 557 subjects with asthma from the Swedish GA(2)LEN study. Allergic sensitization was assessed by skin prick tests to most common aeroallergens. Upper airway comorbidities, smoking habits, smoking exposure during childhood and hormonal status (for women) were questionnaire-assessed. Results Male gender (P < 0.001), greater height (P < 0.001) and sensitization to both perennial allergens and pollen (P < 0.001) are related to higher FeNO levels. Current smoking (P < 0.001) and having both parents smoking during childhood, vs. having neither (P < 0.001) or only one parent smoking (P = 0.002), are related to lower FeNO. Women with menarche between 9 and 11 years of age had lower FeNO than those with menarche between 12 and 14 years of age (P = 0.03) or 15 and 17 years of age (P = 0.003). Conclusions and Clinical relevance Interpreting FeNO levels in clinical practice is complex, and constitutional determinants, as well as smoking and IgE sensitisation, are of importance in asthmatic subjects and should be accounted for when interpreting FeNO levels. Furthermore, menarche age and parental smoking during childhood and their effects on lowering FeNO deserve further studies.

Place, publisher, year, edition, pages
2016. Vol. 46, no 9, 1185-1193 p.
Keyword [en]
asthma, determinants, exhaled nitric oxide, GA(2)LEN, menarche, parental smoking
National Category
Respiratory Medicine and Allergy Immunology in the medical area
Identifiers
URN: urn:nbn:se:uu:diva-310033DOI: 10.1111/cea.12749ISI: 000386955700007PubMedID: 27138350OAI: oai:DiVA.org:uu-310033DiVA: diva2:1054948
Funder
EU, European Research Council, FOOD-CT-2004-506378Swedish Heart Lung FoundationSwedish Asthma and Allergy AssociationThe Karolinska Institutet's Research FoundationSwedish Foundation for Strategic Research
Available from: 2016-12-09 Created: 2016-12-09 Last updated: 2016-12-09Bibliographically approved

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Al-Shamkhi, NasrinAlving, KjellJanson, ChristerMalinovschi, Andrei
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