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

Clin Physiol Funct Imaging. 2009 Jan;29(1):18-23. doi: 10.1111/j.1475-097X.2008.00831.x. Epub 2008 Sep 16.


Introduction: 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 (C(A)NO), airway wall (C(aw)NO), diffusing capacity (D(aw)NO) 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.

Objectives: To calculate NO parameters in a healthy population by collecting NO values at different exhalation flow rates.

Methods: A random sample from the ECRHS II study was investigated. Among the 281 subjects that had performed a bronchial hyperreactivity (BHR)-test, FEV(1.0), IgE and NO-analyses 89 were found to be healthy.

Results: There were no differences in F(E)NO(0.05) or NO parameters between men and women. There were weak correlations between height and both F(E)NO(0.05) (r = 0.23, P = 0.03) and C(aw)NO (r = 0.22, P = 0.04). There was also a correlation between age and C(A)NO (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.

Conclusion: Extended NO analysis is a simple non-invasive tool that gives by far more information than F(E)NO(0.05). Based on our results, we suggest that the values for healthy subjects should be considered to fall between the following ranges: F(E)NO(0.05), 10-30 ppb; C(aw)NO, 50-250 ppb; D(aw)NO, 5-15 ml s(-1); J(aw)NO, 0.8-1.6 nl s(-1); and C(A)NO, 0-4 ppb. Values outside these intervals indicate the need for further investigation to exclude a state of disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Age Factors
  • Algorithms
  • Body Height
  • Breath Tests*
  • Exhalation*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Models, Biological
  • Nitric Oxide / metabolism*
  • Population Surveillance
  • Practice Guidelines as Topic
  • Reference Values
  • Sex Distribution
  • Sex Factors
  • Sweden


  • Nitric Oxide