Ethnic Differences in Fraction of Exhaled Nitric Oxide and Lung Function in Healthy Young Children

Sonnappa, Samatha; Bastardo, Cristina; Stafler, Patrick; Bush, Andrew; Aurora, Paul; Stocks, Janet

doi:10.1378/chest.10-3280

Cited by 25 publications

(21 citation statements)

References 42 publications

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“…1,2 Most studies focused on differences in spirometry, showing that white subjects have, at all ages, larger values of height-normalized forced vital capacity (FVC) and forced expired volume in 1 second (FEV 1 ) than either black or Asian populations; reported differences vary from 8% to 17%. [3][4][5][6][7][8][9][10][11][12][13] Measurements of flow (which may reflect airway caliber rather than volume) have been studied less frequently and have not always been normalized for height. Some reports indicate significant differences in flows among people of various ethnic groups, 3,6,14 whereas others show little or no difference.…”

Section: Discussionmentioning

confidence: 99%

Etiology of Ethnic Differences in Childhood Spirometry

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT:There are ethnic differences in lung function, with white people generally having higher values of FVC and FEV 1 than people of South Asian origin, whereas differences in forced expiratory flows are absent or less marked. The underlying reasons are unknown.WHAT THIS STUDY ADDS: Lung function differences were not explained by cultural, socioeconomic, or perinatal factors, nor by environmental exposures or wheezing illness. This suggests that genetic factors are responsible, and supports the use of ethnicityspecific prediction equations for children of South Asian origin. abstract OBJECTIVES: Age-and height-adjusted spirometric lung function of South Asian children is lower than those of white children. It is unclear whether this is purely genetic, or partly explained by the environment. In this study, we assessed whether cultural factors, socioeconomic status, intrauterine growth, environmental exposures, or a family and personal history of wheeze contribute to explaining the ethnic differences in spirometric lung function. METHODS:We studied children aged 9 to 14 years from a populationbased cohort, including 1088 white children and 275 UK-born South Asians. Log-transformed spirometric data were analyzed using multiple linear regressions, adjusting for anthropometric factors. Five different additional models adjusted for (1) cultural factors, (2) indicators of socioeconomic status, (3) perinatal data reflecting intrauterine growth, (4) environmental exposures, and (5) personal and family history of wheeze.RESULTS: Height-and gender-adjusted forced vital capacity (FVC) and forced expired volume in 1 second (FEV 1 ) were lower in South Asian than white children (relative difference -11% and -9% respectively, P , .001), but PEF and FEF 50 were similar (P $ .5). FEV 1 /FVC was higher in South Asians (1.8%, P , .001). These differences remained largely unchanged in all 5 alternative models. CONCLUSIONS:Our study confirmed important differences in lung volumes between South Asian and white children. These were not attenuated after adjustment for cultural and socioeconomic factors and intrauterine growth, neither were they explained by differences in environmental exposures nor a personal or family history of wheeze. This suggests that differences in lung function may be mainly genetic in origin. The implication is that ethnicity-specific predicted values remain important specifically for South Asian children. Pediatrics 2013;131:e1842-e1849

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Section: Discussionmentioning

confidence: 99%

Etiology of Ethnic Differences in Childhood Spirometry

et al. 2013

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“…Although static lung volume and impulse oscillometry results were related to reference ranges derived from Caucasian subjects, the two groups were matched for ethnic origin and the same reference ranges were used in both groups, thus the comparisons between them were valid. All of the SCD children and the controls were African or Caribbean, thereby avoiding confounding from ethnic differences in exhaled NO (20)(21)(22). It should also be noted that the sample size was relatively small in this study, which may have limited our ability to detect subtle differences between the SCD and control groups.…”

Section: Discussionmentioning

confidence: 94%

“…Using such a technique, SCD children were found to have an elevated airway nitric NO flux, but the alveolar NO concentration did not differ significantly from that found in healthy controls (14). A limitation of that study (14), however, was that the children in the control group were not matched for race and ethnic differences have been reported for F eNO indices (20)(21)(22). Furthermore, as the transfer factor for NO (DLNO) was not measured (14), it was not possible from those results to determine whether any elevation might be due to passive accumulation due to gas exchange impairment or reflected increase in alveolar production.…”

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confidence: 92%

Airway and alveolar nitric oxide production, lung function, and pulmonary blood flow in sickle cell disease

et al. 2015

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Background: Children with sickle cell disease (SCD) often have obstructive lung function abnormalities which could be due to asthma or increased pulmonary blood volume; it is important to determine the underlying mechanism to direct appropriate treatment. In asthmatics, exhaled nitric oxide (F eNO ) is elevated. F eNO , however, can also be raised due to increased alveolar production. Our aim, therefore, was to determine if airway or alveolar NO production differed between SCD children and ethnic and age-matched controls. Methods: Lung function, airway NO flux and alveolar NO production, and effective pulmonary blood flow were assessed in 18 SCD children and 18 ethnic and age-matched controls. results: The SCD children compared to the controls had a higher respiratory system resistance (P = 0.0008), alveolar NO production (P = 0.0224), and pulmonary blood flow (P < 0.0001), but not airway NO flux. There was no significant correlation between F eNO and respiratory system resistance in either group, but in the SCD children, there were correlations between alveolar NO production (P = 0.0006) and concentration (P < 0.0001) and pulmonary blood flow. conclusion: Airway NO flux was not elevated in the SCD children nor correlated with airways obstruction, suggesting that airways obstruction, at least in some SCD children, is not due to asthma.

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“…Genetic differences in FE NO levels have been previously described. 42 Cultural differences are difficult to adjust for and we cannot exclude their influence in questionnaire data. However, we find it likely that cultural differences would affect all questions on respiratory symptoms in the same direction, and accordingly unlikely that such differences would have major impact on symptom patterns depicting the relative frequency of some symptoms as compared to other symptoms.…”

Section: Discussionmentioning

confidence: 99%

Respiratory symptoms, lung functions, and exhaled nitric oxide (FE_NO) in two types of fish processing workers: Russian trawler fishermen and Norwegian salmon industry workers

Shiryaeva

Aasmoe

Straume

et al. 2014

International Journal of Occupational and Environmental Health

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Objective: Respiratory outcomes and work-related factors were studied in two seafood worker populations representing different occupational environments. Methods: Levels of fractional exhaled nitric oxide (FE NO ), spirometric values, prevalence of respiratory symptoms, and self-evaluated exposures were compared between 139 Norwegian salmon workers and 127 Russian trawler workers. Results: Increased odds ratios (ORs) of shortness of breath with wheezing and prolonged cough as general respiratory symptoms were found in salmon workers, while increased ORs of work-related dry cough and running nose were found in trawler fishermen. Both worker groups ranked ''cold work environment,'' ''use of disinfectants,'' and ''contaminated indoor air'' as the first, second, and third most important causes of work-related respiratory symptoms, respectively. Fractional exhaled nitric oxide levels were higher in asthmatic trawler workers compared to asthmatic salmon workers. Conclusions: Respiratory symptoms commonly associated with obstructive airway diseases were more prevalent in salmon workers, while symptoms commonly associated with asthma and short-term effects of cold air exposure were more prevalent in trawler workers.

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Ethnic Differences in Fraction of Exhaled Nitric Oxide and Lung Function in Healthy Young Children

Cited by 25 publications

References 42 publications

Etiology of Ethnic Differences in Childhood Spirometry

Etiology of Ethnic Differences in Childhood Spirometry

Airway and alveolar nitric oxide production, lung function, and pulmonary blood flow in sickle cell disease

Respiratory symptoms, lung functions, and exhaled nitric oxide (FE_NO) in two types of fish processing workers: Russian trawler fishermen and Norwegian salmon industry workers

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Ethnic Differences in Fraction of Exhaled Nitric Oxide and Lung Function in Healthy Young Children

Cited by 25 publications

References 42 publications

Etiology of Ethnic Differences in Childhood Spirometry

Etiology of Ethnic Differences in Childhood Spirometry

Airway and alveolar nitric oxide production, lung function, and pulmonary blood flow in sickle cell disease

Respiratory symptoms, lung functions, and exhaled nitric oxide (FENO) in two types of fish processing workers: Russian trawler fishermen and Norwegian salmon industry workers

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Respiratory symptoms, lung functions, and exhaled nitric oxide (FE_NO) in two types of fish processing workers: Russian trawler fishermen and Norwegian salmon industry workers