Extended NO analysis in a healthy subgroup of a random sample from a Swedish population

There is an interest in modelling exhaled nitric oxide (NO). Studies have shown that flow-independent NO parameters i.e. NO of the alveolar region (CANO), airway wall (CawNO), diffusing capacity (DawNO) and flux (J(aw)NO), are altered in several disease states such as asthma, cystic fibrosis, alveolitis and chronic obsmuctive pulmonary disease (COPD). However, values from a healthy population are missing. To calculate NO parameters in a healthy population by collecting NO values at different exhalation flow rates. A random sample from the ECRHS II study was investigated. Among the 281 subjects that had performed a bronchial hyperreactivity (BHR)-test, FEV1.0, IgE and NO-analyses 89 were found to be healthy. There were no differences in FENO0.05 or NO parameters between men and women. There were weak correlations between height and both FENO0.05 (r = 0.23, P = 0.03) and CawNO (r = 0.22, P = 0.04). There was also a correlation between age and CANO (r = 0.28, P = 0.007). When controlled for gender, this correlation was more powerful in women (r = 0.51, P = 0.001) but did not remain for male subjects. Extended NO analysis is a simple non-invasive tool that gives by far more information than FENO0.05. Based on our results, we suggest that the values for healthy subjects should be considered to fall between the following ranges: FENO0.05, 10-30 ppb; CawNO, 50-250 ppb; DawNO, 5-15 ml s(-1); J(aw)NO, 0.8-1.6 nl s(-1); and CANO, 0-4 ppb. Values outside these intervals indicate the need for further investigation to exclude a state of disease.