种族对FeNO值有重大影响
2018/06/04
摘要
背景：研究发现种族可影响呼出气一氧化氮（FeNO）。因而我们有必要调查不同种族的界值以完善临床应用。
目的：通过分析2007年至2012年国家健康与营养调查机构收集的FeNO数据，调查不同种族 的界值。
方法：这项研究包括23,433名受试者。排除包含混杂因素的受试者后，有11,084名受试者适合进行数据分析。根据年龄和患有过敏性气道炎症的概率，受试者被分为4组。在所有组中分析了西班牙裔美国人、白人、黑人和其他种族的FeNO的几何平均值和第5，第50和第95百分位数。
结果：与白人受试者相比，黑人受试者FeNO的几何平均值在儿童中高出36％到41％，在成人中高出5％到8％。与非西班牙裔白人儿童相比，西班牙裔儿童的FeNO值显着增高（14％至19％）; 然而，这些差异在成人中并不显着。与白人受试者相比，其他种族受试者的FeNO值显著增高：其中儿童增高24-54％，成人增高9-29％。 此外，对于正常健康的黑人儿童，第95百分位数是40.2 ppb，显着高于当前指南推荐的界值。
结论：尽管种族之间FeNO值存在显着差异，但目前50 ppb的界值足以将健康人与成年哮喘人群分开。 但是，对于黑人儿童，我们建议将界值从35增加到40 ppb，以避免不必要的诊断和治疗。
Race and ethnicity have significant influence on fractional exhaled nitric oxide
Dong Wang, et al
Abstract
BACKGROUND：Race and ethnicity have been shown to influence fractional exhaled nitric oxide (FeNO). There is a need to investigate cutoff points for different races and ethnicities to improve clinical application.
OBJECTIVE：To investigate cutoff points for different races and ethnicities by analyzing the FeNO data collected by the National Health and Nutrition Examination Survey from 2007 to 2012.
METHODS：This study included 23,433 participants. After excluding participants with confounding factors, 11,084 participants were eligible for data analysis. Based on age and the probability of having allergic airway inflammation, participants were divided into 4 groups. The geometric mean and 5th, 50th, and 95th percentiles of FeNO in Hispanic, white, black, and other races were analyzed in all groups.
RESULTS：Compared with white participants, the geometric mean for FeNO in black participants was 36% to 41% higher in children and 5% to 8% higher in adults. Hispanic children had significantly higher FeNO values (14% to 19%) compared with non-Hispanic white children; however, those differences were not significant in adults. Other races had significantly higher FeNO values in children (24–54%) and adults (9–29%) compared with white participants. Further, for normal healthy black children, the 95th percentile was 40.2 parts per billion (ppb), which is significantly higher than the cutoff point recommended by current guidelines.
CONCLUSIONS：Although there are significant differences in FeNO values among races and ethnicities, the current cutoff point at 50 ppb is sufficient to separate healthy from asthmatic populations in adults. However, for black children, we suggest increasing the cutoff point from 35 to 40 ppb to avoid unnecessary diagnosis and treatment.
背景：研究发现种族可影响呼出气一氧化氮（FeNO）。因而我们有必要调查不同种族的界值以完善临床应用。
目的：通过分析2007年至2012年国家健康与营养调查机构收集的FeNO数据，调查不同种族 的界值。
方法：这项研究包括23,433名受试者。排除包含混杂因素的受试者后，有11,084名受试者适合进行数据分析。根据年龄和患有过敏性气道炎症的概率，受试者被分为4组。在所有组中分析了西班牙裔美国人、白人、黑人和其他种族的FeNO的几何平均值和第5，第50和第95百分位数。
结果：与白人受试者相比，黑人受试者FeNO的几何平均值在儿童中高出36％到41％，在成人中高出5％到8％。与非西班牙裔白人儿童相比，西班牙裔儿童的FeNO值显着增高（14％至19％）; 然而，这些差异在成人中并不显着。与白人受试者相比，其他种族受试者的FeNO值显著增高：其中儿童增高24-54％，成人增高9-29％。 此外，对于正常健康的黑人儿童，第95百分位数是40.2 ppb，显着高于当前指南推荐的界值。
结论：尽管种族之间FeNO值存在显着差异，但目前50 ppb的界值足以将健康人与成年哮喘人群分开。 但是，对于黑人儿童，我们建议将界值从35增加到40 ppb，以避免不必要的诊断和治疗。
（复旦大学附属中山医院 呼吸内科 罗锦龙 摘译 杨冬 审校）
（Ann Allergy Asthma Immunol, 2018 Feb 3. ）
（Ann Allergy Asthma Immunol, 2018 Feb 3. ）
Race and ethnicity have significant influence on fractional exhaled nitric oxide
Dong Wang, et al
Abstract
BACKGROUND：Race and ethnicity have been shown to influence fractional exhaled nitric oxide (FeNO). There is a need to investigate cutoff points for different races and ethnicities to improve clinical application.
OBJECTIVE：To investigate cutoff points for different races and ethnicities by analyzing the FeNO data collected by the National Health and Nutrition Examination Survey from 2007 to 2012.
METHODS：This study included 23,433 participants. After excluding participants with confounding factors, 11,084 participants were eligible for data analysis. Based on age and the probability of having allergic airway inflammation, participants were divided into 4 groups. The geometric mean and 5th, 50th, and 95th percentiles of FeNO in Hispanic, white, black, and other races were analyzed in all groups.
RESULTS：Compared with white participants, the geometric mean for FeNO in black participants was 36% to 41% higher in children and 5% to 8% higher in adults. Hispanic children had significantly higher FeNO values (14% to 19%) compared with non-Hispanic white children; however, those differences were not significant in adults. Other races had significantly higher FeNO values in children (24–54%) and adults (9–29%) compared with white participants. Further, for normal healthy black children, the 95th percentile was 40.2 parts per billion (ppb), which is significantly higher than the cutoff point recommended by current guidelines.
CONCLUSIONS：Although there are significant differences in FeNO values among races and ethnicities, the current cutoff point at 50 ppb is sufficient to separate healthy from asthmatic populations in adults. However, for black children, we suggest increasing the cutoff point from 35 to 40 ppb to avoid unnecessary diagnosis and treatment.
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小气道功能障碍：过敏性鼻炎与过敏性哮喘的联系
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年轻哮喘患者中血清IgE抗体的缺乏提示非2型超敏反应性疾病
