Patterns and determinants of exhaled nitric oxide trajectories in schoolchildren over a 7-year period. Issue 1 (2nd July 2020)

• Record Type: Journal Article
• Authors: Garcia, Erika; Zhang, Yue; Rappaport, Edward B.; Berhane, Kiros; Muchmore, Patrick; Silkoff, Philip E.; Molshatzki, Noa; Gilliland, Frank D.; Eckel, Sandrah P.
• Is Part Of: European respiratory journal. Volume 56:Issue 1(2020)
• Publication Date: 2020-07-02
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiration -- Periodicals; 616.2
• DOI: 10.1183/13993003.00011-2020
• Languages: English
• ISSNs: 0903-1936

Abstract

Fractional exhaled nitric oxide ( F ENO50 ), a marker of allergic airway inflammation, is used in respiratory research and asthma clinical care; however, its trajectory with increasing age during childhood has not been well characterised. We examined F ENO50 longitudinally during a period of important somatic growth to describe trajectories across childhood and adolescence in healthy participants and evaluate clinical factors as potential determinants of trajectories. F ENO50 was collected at six visits over 8 years in a population-based cohort of 1791 schoolchildren without asthma (median age at entry 8.4 years). Smooth sex-specific F ENO50 trajectories were estimated using generalised additive mixed models, with participant-level random effects. We evaluated whether sex-specific trajectories were influenced by race/ethnicity, body mass index (BMI) percentile, allergic rhinitis or puberty. Different F ENO50 patterns were observed by sex in later childhood and several factors were associated with either F ENO50 level or change in F ENO50 as participants aged. F ENO50 –age trajectories were similar by sex until age ∼11.5 years, after which males had greater F ENO50 change than females. This divergence in F ENO50 –age trajectories coincides with puberty. Males with higher starting BMI percentile had attenuated F ENO50 –age slopes. Among males, F ENO50 levels were lower in non-Hispanic white subjects. Among both sexes, participants with rhinitis had higher F ENO50 . F ENO50 levels within individuals tracked over time; however, there was considerable variation in F ENO50 patterns across participants. F ENO50 trajectories from longitudinal data provide evidence of sex differences coinciding with puberty, suggesting potential hormone link. Improved understanding of determinants of F ENO50 trajectories is needed to realise the potential for using individualised predicted F ENO50 trajectories. Longitudinal F ENO50 trajectories in healthy children aged 8–16 years displayed a similar upward trend in males and females until age 11.5, after which males had higher F ENO50 . Males with higher starting BMI percentile had attenuated F ENO50 slopes with age. https://bit.ly/2UMb8mI