Abstract
Aims. To establish FeNO norms for healthy Tunisian adults aged 18–60 years and to prospectively assess their reliability. Methods. This was a cross-sectional analytical study. A convenience sample of healthy Tunisian adults was recruited. Subjects responded to a medical questionnaire, and then FeNO levels were measured by an online method (Medisoft, Sorinnes (Dinant), Belgium). Clinical, anthropometric, and plethysmographic data were collected. All analyses were performed on natural logarithm values of FeNO. Results. 257 adults (145 males) were retained. The proposed reference equation to predict FeNO value is lnFeNO (ppb) = 3.47−0.56× height (m). After the predicted FeNO value for a given adult was computed, the upper limit of normal could be obtained by adding 0.60 ppb. The mean ± SD (minimum-maximum) of FeNO (ppb) for the total sample was 13.54 ± 4.87 (5.00–26.00). For Tunisian and Arab adults of any age and height, any FeNO value greater than 26.00 ppb may be considered abnormal. Finally, in an additional group of adults prospectively assessed, we found no adult with a FeNO higher than 26.00 ppb. Conclusion. The present FeNO norms enrich the global repository of FeNO norms that the clinician can use to choose the most appropriate norms.
Highlights
The measurement of the fraction of nitric oxide in exhaled breath (FeNO) is recognized as an accurate, reproducible, and completely noninvasive diagnostic test for airway disease [1]
Between the males and females of the equation group (Table 1 and Supplemental Table 3), there was a significant difference in anthropometric data and plethysmographic data expressed in absolute values (FVC, FEV1, FEV1/FVC, peak expiratory flow (PEF), MMEF, MEF50, MEF75, TLC, TGV, and RV) or expressed as a percentage of predicted values (FVC, FEV1, MMEF, TLC, and TGV)
The null hypothesis that we would see no difference in the means of the measured and predicted FeNO mean values was rejected
Summary
The measurement of the fraction of nitric oxide in exhaled breath (FeNO) is recognized as an accurate, reproducible, and completely noninvasive diagnostic test for airway disease [1]. To the best of our knowledge, FeNO norms are available only for some adult populations, mainly for Caucasians ones [9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24] These norms can be used in clinical practice, provided that the study characteristics (population, sampling, and objective measures) are taken into consideration when such an equation is used for the interpretation of FeNO values [1, 7]. (3) if needed to establish FeNO norms and to prospectively assess their reliability
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