Determinants of Fractional Exhaled Nitric Oxide in a Population-Based Cohort: The Role of Lung Volumes and Body Composition.

IF 2.6 3区医学 Q2 RESPIRATORY SYSTEM

Respiration Pub Date : 2026-03-20 DOI:10.1159/000551192

Charmaine J M Lim, Oliver Helk, Florian Krach, Alina Ofenheimer, Tobias L Mraz, Frits M E Franssen, Emiel F M Wouters, Robab Breyer-Kohansal, Marie-Kathrin Breyer

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引用次数: 0

Abstract

Introduction: Fractional exhaled nitric oxide (FeNO) is a clinically utilised marker of type 2 airway inflammation and is used to guide treatment in asthma. We aimed to resolve the ongoing scientific debate, whether FeNO is affected by obesity-related changes in inflammation and airway architecture.

Methods: We assessed the association of FeNO levels with obesity markers and lung function parameters in 1,205 respiratory-healthy adult participants (43.1% males) aged 18-82 years from the Austrian LEAD cohort with mean body mass index (BMI) of 26.4 ± 4.7 kg/m2. Sensitivity analyses were conducted in the respiratory-healthy obese subpopulation (n = 230).

Results: Median FeNO levels were 16.0 (interquartile range [IQR]: 12.0-23.0; 95th percentile: 34.0) ppb in the respiratory-healthy any-weight population, with higher levels reported in the respiratory-healthy obese (17.5 [IQR: 12.0-23.0] ppb; 95th percentile: 35.0 ppb) population. Unadjusted multiple regression analyses showed that BMI; fat mass index, visceral adipose tissue index (VATI), and appendicular lean mass index; and residual volume (RV) %predicted were associated with higher FeNO levels in respiratory-healthy any-weight individuals. In obese respiratory-healthy individuals, only VATI showed statistically significant association with FeNO. After adjusting for the confounders such as age, sex, and smoking status, all assessed parameters lost their significance in the assessed populations except for RV- and total lung capacity Z-scores, although at low effect size.

Conclusion: Our results demonstrate no independent effect of obesity markers on FeNO levels after adjustments for age, sex, and smoking status.

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以人群为基础的队列中FeNO的决定因素：肺容量和身体组成的作用。

前言：呼气一氧化氮分数（FeNO）是临床上常用的2型气道炎症标志物，用于指导哮喘的治疗。目的：我们旨在解决正在进行的科学争论，是否FeNO受到肥胖相关的炎症和气道结构变化的影响。方法：我们评估了来自奥地利LEAD队列的1205名18-82岁、平均体重指数（BMI）为26.4±4.7kg/m2的呼吸健康成人（43.1%男性）的FeNO水平与肥胖标志物和肺功能参数的关系。对呼吸健康肥胖亚群（n=230）进行敏感性分析。结果：呼吸健康人群中FeNO水平中位数为16.0（四分位数[IQR]: 12.0 - 23.0；第95百分位数：34.0）ppb，呼吸健康肥胖人群中FeNO水平更高（17.5 [IQR: 12.0 - 23.0] ppb；第95百分位数：35.0 ppb）。未经调整的多元回归分析显示，BMI；脂肪量指数、内脏脂肪组织指数（VATI）、阑尾瘦质量指数；预测的残气量（RV） %与呼吸健康的任何体重个体较高的FeNO水平相关。在肥胖的呼吸健康个体中，只有VATI与FeNO有统计学意义的关联。在调整了年龄、性别和吸烟状况等混杂因素后，除了残气量和总肺活量z分数外，所有评估参数在评估人群中都失去了显著性，尽管效应量很低。结论：我们的研究结果表明，在调整了年龄、性别和吸烟状况后，肥胖标志物对FeNO水平没有独立的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Respiration 医学-呼吸系统

CiteScore

7.30

自引率

5.40%

发文量

审稿时长

4-8 weeks

期刊介绍： ''Respiration'' brings together the results of both clinical and experimental investigations on all aspects of the respiratory system in health and disease. Clinical improvements in the diagnosis and treatment of chest and lung diseases are covered, as are the latest findings in physiology, biochemistry, pathology, immunology and pharmacology. The journal includes classic features such as editorials that accompany original articles in clinical and basic science research, reviews and letters to the editor. Further sections are: Technical Notes, The Eye Catcher, What’s Your Diagnosis?, The Opinion Corner, New Drugs in Respiratory Medicine, New Insights from Clinical Practice and Guidelines. ''Respiration'' is the official journal of the Swiss Society for Pneumology (SGP) and also home to the European Association for Bronchology and Interventional Pulmonology (EABIP), which occupies a dedicated section on Interventional Pulmonology in the journal. This modern mix of different features and a stringent peer-review process by a dedicated editorial board make ''Respiration'' a complete guide to progress in thoracic medicine.