Fractional exhaled nitric oxide is correlated with pulmonary function in patients with stable chronic obstructive pulmonary disease
Keywords:
Chronic obstructive pulmonary disease, Airway inflammation, Lung functionAbstract
Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow obstruction and airway inflammation. Nitric oxide (NO) is a known marker for airway inflammation in several lung diseases. Measurement of fractional exhaled nitric oxide (FeNO) is an easy and non-invasive method for assessing airway inflammation. Whether FeNO levels are associated with lung functions remain to be established. We evaluated airway inflammation and its correlations with pulmonary functions in stable COPD patients. Fifty stable COPD patient and 50 control males aged 44 to 83 years old participated in this study. All subjects underwent FeNO testing and spirometry. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2015 Guidelines were used to classify the severity of airflow limitation in COPD patients. The proportion of patient with COPD 1, 2, 3, and 4 were 28%, 38%, 32%, and 2%, respectively. Mean FeNO levels were significantly higher in COPD patients than in controls (35.3 ± 8.1 vs. 11.4 ± 4.4 ppb, p<0.001). FeNO levels significantly increased in proportion to severity of COPD. Moreover, FeNO level in COPD patients was inversely correlated with pulmonary function as assessed by %predicted FVC (r = -0.527), FEV1 (r = -0.770), MEF (r = -0.693) and PEF (r = -0.540) (p<0.001). The present study suggests that FeNO level has clinical relevance, since it increases with increasing severity of COPD and is negatively associated with pulmonary function.
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