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Multicenter Study
. 2024 Sep 16;25(1):340.
doi: 10.1186/s12931-024-02938-4.

Reference values for exhaled nitric oxide in healthy children aged 6-18 years in China: a cross-sectional, multicenter clinical study

Yazun Liu #  1 , Hao Zhang #  2 , Jinrong Wang #  3 , Yuling Han #  4 , Chunhong Pan #  5 , Wenhui Jiang #  6 , Chunyan Ma #  7 , Yongsheng Shi #  8 , Chunmei Jia #  9 , Yuehua Zhang #  10 , Ming Li #  11 , Fei Wang #  12 , Yanyan Yu #  13 , Yong Feng #  14 , Li Liu #  15 , Aihong Liu #  16 , Qiaoling Zhang #  17 , Zhen Long #  18 , Fuli Dai #  19 , Yanli Zhang #  20 , Minghong Ji #  21 , Dongjun Ma #  22
Affiliations
Multicenter Study

Reference values for exhaled nitric oxide in healthy children aged 6-18 years in China: a cross-sectional, multicenter clinical study

Yazun Liu et al. Respir Res. .

Abstract

Background: The reference values of eNO have certain differences among people of different countries and races. We aimed to obtain the reference value of eNO in healthy children and adolescents (6-18 years old) in China and to explore the associations between the reference values with ages, gender, heights, BMI, and regions.

Methods: We measured FeNO50 levels in 5949 healthy Chinese children and adolescents, FeNO200 and CaNO levels in 658 participants from 16 provinces of 7 administrative areas in China aged 6-18. All persons were studied after obtaining informed consent from children and their parents.

Results: The mean FeNO50 of 5949 Chinese children and adolescents aged 6-18 years was 14.1 ppb, with a 95% confidence interval of 1-38.1 ppb. The mean FeNO200 of 658 persons was 6.9 ppb with a 95% upper confidence interval of 15.0 ppb, and the mean CaNO was 3.0 ppb with a 95% upper confidence interval of 11.2 ppb. In the 6-11 age group, age and height were correlated with the logarithm of FeNO50 (P < 0.001, P < 0.05). There was no significant correlation between the logarithm of FeNO200 and gender, age, height and BMI (all P > 0.05). The logarithm of CaNO was correlated with gender (P < 0.05). In the 12-18 age group, gender, height, and region were correlated with the logarithm of FeNO50 (all P < 0.001). There was only a weak correlation between the logarithm of FeNO200 and height (P < 0.001). The logarithm of CaNO was negatively correlated with age (P < 0.05).

Conclusions: Higher FeNO50, FeNO200 and CaNO values were found in healthy children and adolescents in China compared with foreign reports, and is affected by age, height, gender, and region. This study provides useful references for clinical application of eNO in children, especially Asian children.

Keywords: CaNO; Children and adolescents; FeNO200; FeNO50; Reference values.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Schematic presentation of the recruitment of healthy children
Fig. 2
Fig. 2
Distribution of FeNO50. (A) FeNO50 in children aged 6–18 years; (B) FeNO50 in children aged 6–11 years; (C) FeNO50 in children aged 12–18 years
Fig. 3
Fig. 3
Distribution of FeNO200. (A) FeNO200 in children aged 6–18 years; (B) FeNO200 in children aged 6–11 years; (C) FeNO200 in children aged 12–18 years
Fig. 4
Fig. 4
Distribution of CaNO. (A) CaNO in children aged 6–18 years; (B) CaNO in children aged 6–11 years; (C) CaNO in children aged 12–18 years
Fig. 5
Fig. 5
FeNO50, FeNO200 and CaNO values in children of all ages
Fig. 6
Fig. 6
FeNO50, FeNO200 and CaNO values of children with different heights
Fig. 7
Fig. 7
FeNO50 values of children with different regions
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