Jung-Won Lee1, Jung Yeon Shim1, Ji-Won Kwon2, Hyung Young Kim3, Ju-Hee Seo4, Byoung-Ju Kim5, Hyo-Bin Kim6, So-Yeon Lee7, Gwang-Cheon Jang8, Dae-Jin Song9, Woo Kyung Kim10, Young-Ho Jung11, Soo-Jong Hong12. 1. a Department of Pediatrics , Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine , Seoul , Korea . 2. b Department of Pediatrics , Seoul National University Bundang Hospital , Sungnam , Korea . 3. c Department of Pediatrics , Pusan National University Yangsan Hospital , Pediatrics , Yangsan , Korea . 4. d Department of Pediatrics , Korea Cancer Center Hospital , Seoul , Korea . 5. e Department of Environmental Health , College of Medicine University of Cincinnati , Cincinnati , OH , USA . 6. f Department of Pediatrics , Inje University Sanggye Paik Hospital , Seoul , Korea . 7. g Department of Pediatrics , Hallym University Sacred Heart Hospital, Hallym University College of Medicine , Anyang , Korea . 8. h Department of Pediatrics , National Health Insurance Corporation Ilsan Hospital , Ilsan , Korea . 9. i Department of Pediatrics , Korea University Guro Hospital, Korea University College of Medicine , Seoul , Korea . 10. j Department of Pediatrics , Inje University Seoul Paik Hospital , Seoul , Korea . 11. k Department of Pediatrics , Bundang CHA Medical Center, CHA University School of Medicine , Seongnam , Korea , and. 12. l Department of Pediatrics , Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine , Seoul , Korea.
Abstract
OBJECTIVE: Fractional concentration of exhaled nitric oxide (FeNO) is a known marker of airway inflammation. The aims of this study were to evaluate FeNO, impulse oscillometry (IOS), and spirometry in preschool children and to investigate their relationship with wheeze and airway hyperresponsiveness (AHR). METHODS: We performed a population-based, cross-sectional study with 561 children aged 5-6 years. A total of 544 children completed a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and eligible for the study. We measured FeNO, spirometry, methacholine bronchial provocation, and IOS. AHR was defined as the induction of a 20% decrease in FEV(1)(PC(20)) by a methacholine concentration ≤8.0 mg/dL. RESULTS: Children who had wheeze or AHR had higher FeNO levels than children without these symptoms. However, neither IOS nor spirometry parameters showed significant differences between children with wheeze or AHR and those without. FeNO was associated with AHR, whereas IOS or spirometry parameters showed no association. Mean FeNO levels were positively correlated with a dose-response slope for methacholine, but neither IOS nor spirometry parameters showed significant correlations. CONCLUSIONS: FeNO is a more sensitive measurement of AHR and wheeze than spirometry or IOS in preschool children.
OBJECTIVE: Fractional concentration of exhaled nitric oxide (FeNO) is a known marker of airway inflammation. The aims of this study were to evaluate FeNO, impulse oscillometry (IOS), and spirometry in preschool children and to investigate their relationship with wheeze and airway hyperresponsiveness (AHR). METHODS: We performed a population-based, cross-sectional study with 561 children aged 5-6 years. A total of 544 children completed a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and eligible for the study. We measured FeNO, spirometry, methacholine bronchial provocation, and IOS. AHR was defined as the induction of a 20% decrease in FEV(1)(PC(20)) by a methacholine concentration ≤8.0 mg/dL. RESULTS:Children who had wheeze or AHR had higher FeNO levels than children without these symptoms. However, neither IOS nor spirometry parameters showed significant differences between children with wheeze or AHR and those without. FeNO was associated with AHR, whereas IOS or spirometry parameters showed no association. Mean FeNO levels were positively correlated with a dose-response slope for methacholine, but neither IOS nor spirometry parameters showed significant correlations. CONCLUSIONS:FeNO is a more sensitive measurement of AHR and wheeze than spirometry or IOS in preschool children.
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