Determinants of exhaled nitric oxide levels in healthy, nonsmoking African American adults.
BACKGROUND
Asthma is a significant cause of morbidity and mortality for African Americans. Fraction of exhaled nitric oxide (FeNO) levels are increased in patients with asthma, and airway levels of nitric oxide metabolites regulate airway inflammation and airway diameter. More needs to be known about the factors that regulate FeNO. There is a need for FeNO reference values for African Americans.


OBJECTIVE
We sought to establish reference values and identify factors associated with FeNO levels in healthy African American adults.


METHODS
FeNO levels were measured in 895 healthy, nonsmoking African Americans between the ages of 18 and 40 years. FeNO measurements were repeated in 84 subjects. Factors potentially associated with FeNO were measured, including blood pressure, height, weight, and serum total IgE, eosinophil cationic protein, C-reactive protein, and nitrate levels. Data on respiratory symptoms, including upper respiratory tract infection (URI) symptoms, were collected. Univariate and multivariate analyses of the relationship between these variables and FeNO levels were performed.


RESULTS
In healthy, nonsmoking African Americans FeNO levels were stable during repeated measurements (intraclass correlation coefficient, 0.81). Sex (P < .0001), serum total IgE levels (P < .0001), and current URI symptoms (P = .0002) contributed significantly to FeNO variability but together accounted for less than 50% of the variation in FeNO levels.


CONCLUSIONS
The high correlation between repeated measurements of FeNO and the low correlation coefficients of known factors associated with FeNO suggest that other factors might contribute substantially to variability of FeNO levels in African Americans.
Department of Medicine, Division of Rheumatology and Immunology, Duke University Medical Center, Durham, NC 27710, USA. marc.levesque@duke.edu
Marc C
MC
Levesque
David W
DW
Hauswirth
Sabrena
S
Mervin-Blake
Carolyn A
CA
Fernandez
Kistie B
KB
Patch
Katie M
KM
Alexander
Sallie
S
Allgood
Patrice D
PD
McNair
Andrew S
AS
Allen
John S
JS
Sundy
D000328:Adult; D001741:Black or African American; D015331:Cohort Studies; D045853:Exhalation; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D015999:Multivariate Analysis; D009569:Nitric Oxide; D012016:Reference Values; D012141:Respiratory Tract Infections / Q000378:metabolism; D012727:Sex Characteristics
D009569:Nitric Oxide; D007073:Immunoglobulin E