title: The role of FENO and spirometry in the evaluation of obstruction in pediatric asthma.
abstract: BACKGROUND
  The fractional exhaled nitric oxide concentration (FENO) is used as a noninvasive biomarker for asthmatic inflammation. The role in establishing an asthma diagnosis is still under research. Spirometry remains the main investigation for the diagnosis and monitoring of asthma.
  
  
  OBJECTIVE
  The aim of the study was to assess the correlation between FENO level and the values of spirometric parameters defining airflow obstruction.
  
  
  METHODS
  The longitudinal study included a group of 89 children admitted to the Pediatric Clinic of "Grigore Alexandrescu" Emergency Clinical Hospital for Children. The inclusion criteria were: (i) a previously known diagnosis of asthma, (ii) age range between 5 and 18 years old. All patients underwent pulmonary function testing and measurement of FENO.
  
  
  RESULTS
  Significant correlations were identified between FENO and a part of spirometric parameters: MEF75 (p=0.007), MEF50 (p=0.0.28), MEF25 (p=0.011) and PEF (p=0.020), but not with FEV1 (p=0.090), nor FVC (p=0.308). However, multiple linear regression analysis revealed that spirometric parameters poorly predict FENO variation (R=0.062, p=0.82). In adition, binary logistic regression analysis (LR) showed that FENO can not be used as a reliable biomarker (p=0.169) for the estimation of the risk for obstructive dysfunction.
  
  
  CONCLUSIONS
  The level of exhaled nitric oxide does not correlate with the values of spirometric values. More studies with a large number of patients are needed for establishing the role of FENO in the evaluation of airflow obstruction.
authors.forename: Cristiana
authors.initials: C
authors.lastname: Stănciulescu
authors.forename: Mirela
authors.initials: M
authors.lastname: Chiru
authors.forename: Alina
authors.initials: A
authors.lastname: Oprea
authors.forename: Daniela
authors.initials: D
authors.lastname: Păcurar
authors.forename: Carmen
authors.initials: C
authors.lastname: Zăpucioiu
authors.forename: Elena
authors.initials: E
authors.lastname: Petrişor
authors.forename: Dumitru
authors.initials: D
authors.lastname: Orăşeanu
mesh_terms: D000293:Adolescent; D000402:Airway Obstruction / Q000209:etiology / Q000503:physiopathology*; D001249:Asthma / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology*; D015415:Biomarkers / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D045853:Exhalation; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008450:Maximal Midexpiratory Flow Rate; D009569:Nitric Oxide / Q000378:metabolism*; D010366:Peak Expiratory Flow Rate; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012383:Romania; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013147:Spirometry
chemical_list: D015415:Biomarkers; D009569:Nitric Oxide