title: Association between Body Mass Index (BMI) and fraction of exhaled nitric oxide (FeNO) levels in the National Health and Nutrition Examination Survey (NHANES) 2007-2010.
abstract: Obesity is characterised by chronic, low-grade systemic inflammation. Elevated FeNO levels reflect airway inflammation in various lung diseases including asthma.
  
  
  
  This is a cross-sectional analysis of data from NHANES 2007-2010. Participants younger than 20 years old with history of cough/cold symptoms in the past 7 days, smoking, exercise in the previous hour, consumption of nitric oxide rich meats/vegetables, or use of inhaled corticosteroids during the previous 2 days were excluded. BMI (in kg/m2) was divided in to 4 categories: underweight (UW) (0-18.5), Normal (N) (≥18.5 to <25), Overweight (OW) (≥25 and <30) and Obese (O) ≥30.
  
  
  
  There were a total of 149,629,652 weighted participants: UW (22,235,218), N (45,021,536), OW (5,1670,522) and O (50,199,974); 50.36% were men and 49.63% were women. The mean age increased with BMI category [p<.0001]. Mean FeNO levels (in ppb) increased with increasing BMI category: UW (12.52±1.05) N (16.25±0.64), OW (16.62±0.34), and O (16.78±0.39) [p=0.0035]. FEV1/FVC (%) decreased with increasing BMI category: UW (80.68) compared to N (78.51), OW (77.67) and O (78.72) [p=0.0014]. There is a weak yet statistically significant correlation between FeNO levels and both age, BMI. Multivariate analysis predicting FeNO based on BMI category, adjusting for age, gender, race and airway obstruction found age less than 60 years, male gender, certain races and UW BMI category were associated with statistically significantly lower FeNO levels.
  
  
  
  Older age and male gender are associated with increased FeNO levels. Controlling for age, gender, and race, obese individuals have a statistically significantly higher FENO than underweight individuals.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Houston Methodist Hospital, Houston, TX, USA. Electronic address: auppalapati@houstonmethodist.org.
authors.forename: Aditya
authors.initials: A
authors.lastname: Uppalapati
authors.affiliation: Division of Endocrinology and Metabolism, The University of Texas Medical Branch (UTMB), Galveston, TX, USA.
authors.forename: Sindhura
authors.initials: S
authors.lastname: Gogineni
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Saint Louis University School of Medicine, Saint Louis, MO, USA.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Espiritu
mesh_terms: D000328:Adult; D000367:Age Factors; D000402:Airway Obstruction; D001249:Asthma / Q000378:metabolism; D015992:Body Mass Index; D001944:Breath Tests; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000378:metabolism*; D058085:Iron Compounds / Q000378:metabolism; D008168:Lung / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009569:Nitric Oxide / Q000378:metabolism*; D009749:Nutrition Surveys; D009765:Obesity / Q000150:complications / Q000378:metabolism*; D050177:Overweight; D012016:Reference Values; D012737:Sex Factors; D013851:Thinness; D055815:Young Adult
chemical_list: D058085:Iron Compounds; D009569:Nitric Oxide
keywords: BMI; FENO; Inflammation