title: Use of Exhaled Nitric Oxide as a Biomarker in Diagnosis and Management of Chronic Obstructive Pulmonary Disease.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD), a progressive and nonreversible disease, is a leading cause of mortality and morbidity throughout the world. Because airway inflammation is a hallmark of COPD, it has been proposed that measuring exhaled nitric oxide, a marker of inflammation, in exhaled breath condensate could prove to be an inexpensive and efficient method to detect COPD in outpatient settings.
  
  
  METHODS
  This study used secondary data on a sample of 10,214 individuals 30 years and older from the National Health and Nutrition Examination Survey 2007 to 2010. Binary and ordinal logistic regression analyses were used to test the association of exhaled nitric oxide (eNO) with COPD and COPD severity.
  
  
  RESULTS
  The prevalence of COPD was 7.2%, based on self-reported physician diagnoses and 11.4% based on prebronchodilator spirometry analysis. This study found no statistically significant association between eNO, COPD, and COPD severity (P > .05).
  
  
  CONCLUSIONS
  The findings of this study do not support use of eNO as a biomarker of inflammation in diagnosis and management of COPD.
authors.affiliation: University of North Carolina at Charlotte, Charlotte, NC, USA aarif@uncc.edu.
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Arif
authors.affiliation: Walden University, Minneapolis, MN, USA.
authors.forename: Colin
authors.initials: C
authors.lastname: Mitchell
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D001944:Breath Tests / Q000379:methods; D045853:Exhalation; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000032:analysis*; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000453:epidemiology; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D009569:Nitric Oxide
keywords: COPD severity; GOLD; chronic obstructive pulmonary disease (COPD); exhaled nitric oxide (eNO)