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Original Research: PULMONARY PHYSIOLOGY |

Ethnic Differences in Fraction of Exhaled Nitric Oxide and Lung Function in Healthy Young ChildrenEthnicity and Lung Function in Young Children

Samatha Sonnappa, MD, PhD; Cristina M. Bastardo, MD; Patrick Stafler, MD; Andrew Bush, MD; Paul Aurora, MD, PhD; Janet Stocks, PhD
Author and Funding Information

From the Portex Unit: Respiratory Medicine and Physiology (Drs Sonnappa, Bastardo, Aurora, and Stocks), University College London Institute of Child Health; the Department of Paediatric Respiratory Medicine (Drs Sonnappa, Stafler, and Aurora), Great Ormond Street Hospital for Children NHS Trust; and the Department of Paediatric Respiratory Medicine (Dr Bush), Royal Brompton Hospital and Imperial College, Sydney Street, London, England.

Correspondence to: Samatha Sonnappa, MD, PhD, Portex Unit: Respiratory Medicine and Physiology, University College of London Institute of Child Health and Great Ormond Street Hospital for Children, 30, Guilford St, London, WC1N 1EH, England; e-mail: s.sonnappa@ich.ucl.ac.uk


Funding: This work was supported by Asthma UK, The European Respiratory Society, and Smiths Medical UK.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;140(5):1325-1331. doi:10.1378/chest.10-3280
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Background:  Ethnic differences in lung function in school-aged children and adults are well recognized, but little is known about such differences in preschool children. We investigated whether differences exist in fraction of exhaled nitric oxide (Feno), multiple-breath washout (MBW) indices, specific airways resistance (sRaw), and spirometry indices between healthy preschool children of South Asian and white European origin.

Methods:  Feno, MBW indices (lung clearance index, functional residual capacity, conductive airways inhomogeneity, and acinar airways inhomogeneity), sRaw, and spirometry were measured in healthy South Asian and white children aged 4 to 6 years, and comparisons were made between the two groups. Statistical analyses were by multiple linear regression and t tests.

Results:  Thirty-seven white (mean age 5.8 ± 0.7 years, 49% boys) and 31 South Asian children (mean age 5.4 ± 0.8 years, 52% boys) were recruited. Feno was, on average, 36% higher (P < .05) in South Asian children compared with white children. FVC and FEV1 and fractions thereof (FEV0.75 and FEV0.5) z-scores were significantly lower in South Asian compared with white children by 0.69 (P = .01), 0.76 (P = .004), 0.76 (P = .009), and 0.85 (P = .002) z-scores, respectively, but there were no significant differences in FEV1/FVC, FEF25-75, sRaw, or MBW indices.

Conclusions:  Differences in Feno and forced expiratory lung volumes between South Asian and white children exist from a very young age. Ethnic differences should be taken into account when interpreting lung function results in preschool children for effective management of respiratory conditions.

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