Allergy Asthma Immunol Res.  2015 Jul;7(4):404-408. 10.4168/aair.2015.7.4.404.

Fractional Exhaled Nitric Oxide: Comparison Between Portable Devices and Correlation With Sputum Eosinophils

• Yune S
• Lee JY
• Choi DC
• Lee BJ

• KMID: 2166688
• DOI: http://doi.org/10.4168/aair.2015.7.4.404

Abstract

This study was performed to compare the 2 different portable devices measuring fractional exhaled nitric oxide (FeNO) and to see the correlation between FeNO and induced sputum eosinophil count (ISE). Forty consecutive subjects clinically suspected to have asthma underwent FeNO measurement by NIOX-MINO(R) and NObreath(R) concurrently. All also had induced sputum analysis, methacholine provocation test or bronchodilator response test, and spin prick test. Agreement between the 2 devices was evaluated. The correlation between FeNO and ISE was assessed, as well as the cut-off level of FeNO to identify ISE > or =3%. The intraclass correlation coefficient (ICC) between FeNO levels measured by NIOX-MINO(R) (FeNO(NIOX-MINO)) and NObreath(R) (FeNO(NObreath)) was 0.972 with 95% confidence interval of 0.948-0.985. The 95% limits of agreement were -28.9 to 19.9 ppb. The correlation coefficient between ISE and FeNO(NIOX-MINO) was 0.733 (P<0.001), and 0.751 between ISE and FeNO(NObreath) (P<0.001). The ROC curve found that the FeNO(NIOXMINO) of 37.5 ppb and the FeNO(NObreath) of 36.5 ppb identified ISE > or =3% with 90% sensitivity and 81% specificity. Age, sex, body mass index, smoking history, atopy, and the presence of asthma did not affect the FeNO level and its correlation with ISE. The NIOX-MINO (R) and NObreath(R) agree with each other to a high degree. Both devices showed close correlation with ISE with similar cut-off value in identifying ISE > or =3%.

Keyword

Asthma; nitric oxide; electrochemical technique; eosinophils; sputum

MeSH Terms

Asthma
Body Mass Index
Electrochemical Techniques
Eosinophils*
Methacholine Chloride
Nitric Oxide*
ROC Curve
Smoke
Smoking
Sputum*
Methacholine Chloride
Nitric Oxide
Smoke

Figure

• 

  Fig. 1 (A) Correlation between fractional exhaled nitric oxide levels measured by NObreath® and NIOX-MINO®. (B) Bland-Altman plot shows the agreement between NIOX-MINO® and NObreath®.

• 

  Fig. 2 ROC curve of FeNONIOX-MINO and FeNONObreath to identify ISE≥3%. Area under curve is 0.877 and 0.886, respectively for FeNONIOX-MINO and FeNONObreath. The circle indicates the closest point to the top left-hand corner, which corresponds to 37.5 ppb of FeNONIOX-MINO and 36.5 ppb of FeNONObreath.

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