Fractional Exhaled Nitric Oxide Values in Indigenous Australians 3 to 16 Years of Age

Tamara L. Blake, Anne B. Chang, Mark D. Chatfield, Julie M. Marchant, Helen L. Petsky, Margaret S. McElrea

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    Background: Fractional exhaled nitric oxide (FENO) levels can identify eosinophilic asthma phenotypes. We aimed to determine FENO values of healthy Aboriginal and/or Torres Strait Islander (Indigenous) Australians, differences between these Indigenous ethnic groups, and appropriateness of published cutoff values.

    Methods: We measured FENO levels in 1,036 Indigenous Australians (3-16 years of age). Participants were classified into healthy (ie, no asthma or atopy history) or asthmatic and/or atopic groups.

    Results: Median FENO values and distribution did not differ between Indigenous ethnicities. For healthy participants < 12 years of age (n = 390), 7.2% of our cohort fell into the inflammatory zone of the American Thoracic Society (ATS), National Institute for Health and Care Excellence (NICE), and British Thoracic Society (BTS)/Scottish Intercollegiate Guidelines Network (SIGN) guidelines (cutoff 35 parts per billion [ppb]), but only 3.8% fell into this category when using the Global Initiative for Asthma (GINA) guidelines (50 ppb). Similarly, when using the NICE and BTS/SIGN guidelines (40 ppb) for participants 12 to 16 years of age (n = 213), more healthy participants fell into the inflammatory zone compared with the ATS and GINA guidelines (50 ppb) (9.9% vs 4.7%, respectively).

    Conclusions: FENO values for healthy Indigenous Australians children (3-16 years of age) are likely higher than published white-based values. The GINA recommended cutoff value (> 50 ppb) appears the most appropriate for identifying healthy Indigenous children but requires confirmation from a larger study.

    Original languageEnglish
    Pages (from-to)239-246
    Number of pages8
    Issue number2
    Publication statusPublished - Aug 2019


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