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Tuberculosis & Respiratory Diseases

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Vol.83 No.3
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Clinical Features of Chronic Obstructive Pulmonary Disease with High Fractional Exhaled Nitric Oxide

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2020, v.83 no.3, pp.234-241
https://doi.org/10.4046/trd.2019.0086
Seong Ahn (Chonnam National University)
Tae-Ok Kim (Chonnam National University)
Jinsun Chang (Chonnam National University)
Hong-Joon Shin (Chonnam National University)
Yong-Soo Kwon (Chonnam National University)
Sung Chul Lim (Chonnam National University)
Yu Il Kim (Chonnam National University)
Seong, A. , Tae-Ok, K. , Jinsun, C. , Hong-Joon, S. , Yong-Soo, K. , Sung, C. L. , & Yu, I. K. (2020). Clinical Features of Chronic Obstructive Pulmonary Disease with High Fractional Exhaled Nitric Oxide. Tuberculosis & Respiratory Diseases, 83(3), 234-241, https://doi.org/10.4046/trd.2019.0086
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Abstract

Background: The fractional exhaled nitric oxide (FENO) test is useful in asthma patients. However, a few studies on its usefulness in chronic obstructive pulmonary disease (COPD) patients have been reported. We analyzed the FENO level distribution and clinical characteristics according to the FENO level in COPD patients. Methods: From December 2014 to June 2019, COPD patients who underwent pulmonary function and FENO tests at Chonnam National University Hospital were retrospectively evaluated for FENO, comorbidities, asthma history, blood eosinophil, and pulmonary function test. The high FENO group was defined as those with FENO level>25 parts per billion (ppb). Results: A total of 849 COPD patients (mean age, 70.3±9.4 years) were included. The mean forced expiratory volume at 1 second was 66.5±21.7% and the mean FENO level was 24.3±20.5 ppb. Patients with FENO ≤25 ppb were 572 (67.4%) and those with FENO >25 ppb were 277 (32.6%). Blood eosinophil percentage was significantly higher (4.2±4.8 vs. 2.7±2.5, p<0.001) in patients with the high FENO group than the low FENO group. The high FENO group revealed a significantly higher frequency of patients with blood eosinophil percentage >3% (46.9% vs. 34.8%, p=0.001) and asthma history (25.6% vs. 8.6%, p<0.001) than the lower FENO group. Asthma history, blood eosinophil percentage >3%, and positive bronchodilator response (BDR) were independent risk factors for the high FENO level (adjusted odds ratio [aOR], 3.85; p<0.001; aOR, 1.46; p=0.017; and aOR, 1.57, p=0.034, respectively) in the multivariable analysis. Conclusion: The FENO level distribution varied in COPD patients and the mean FENO value was slightly elevated. Asthma history, eosinophil percent, and positive BDR were independent risk factors for the high FENO level.

keywords
Nitric Oxide, Pulmonary Disease, Chronic Obstructive, Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome

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