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Fraction of exhaled nitric oxide ( F e NO ) norms in healthy North African children 5–16 years old
Author(s) -
Rouatbi Sonia,
Alqodwa Ashraf,
Ben Mdella Samia,
Ben Saad Helmi
Publication year - 2013
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.22721
Subject(s) - medicine , anthropometry , confidence interval , demography , exhaled nitric oxide , population , socioeconomic status , zoology , pediatrics , asthma , environmental health , spirometry , sociology , biology
Aims (i) To identify factors that influence the Fe NO values in healthy North African, Arab children aged 6–16 years; (ii) to test the applicability and reliability of the previously published Fe NO norms; and (iii) if needed, to establish Fe NO norms in this population, and to prospectively assess its reliability. Population and Methods This was a cross‐sectional analytical study. A convenience sample of healthy Tunisian children, aged 6–16 years was recruited. First subjects have responded to two questionnaires, and then Fe NO levels were measured by an online method with electrochemical analyzer (Medisoft, Sorinnes [Dinant], Belgium). Anthropometric and spirometric data were collected. Simple and a multiple linear regressions were determined. The 95% confidence interval (95% CI) and upper limit of normal (ULN) were defined. Results Two hundred eleven children (107 boys) were retained. Anthropometric data, gender, socioeconomic level, obesity or puberty status, and sports activity were not independent influencing variables. Total sample Fe NO data appeared to be influenced only by maximum mid expiratory flow (l sec −1 ; r 2 = 0.0236, P = 0.0516). For boys, only 1st second forced expiratory volume (l) explains a slight (r 2 = 0.0451) but significant Fe NO variability ( P = 0.0281). For girls, Fe NO was not significantly correlated with any children determined data. For North African/Arab children, Fe NO values were significantly lower than in other populations and the available published Fe NO norms did not reliably predict Fe NO in our population. The mean ± SD (95% CI ULN, minimum–maximum) of Fe NO (ppb) for the total sample was 5.0 ± 2.9 (5.4, 1.0–17.0). For North African, Arab children of any age, any Fe NO value greater than 17.0 ppb may be considered abnormal. Finally, in an additional group of children prospectively assessed, we found no child with a Fe NO higher than 17.0 ppb. Conclusion Our Fe NO norms enrich the global repository of Fe NO norms the pediatrician can use to choose the most appropriate norms based on children's location or ethnicity. Pediatr Pulmonol. 2013; 48:981–995. © 2012 Wiley Periodicals, Inc.