Ethnic differences in fraction of exhaled nitric oxide and lung function in healthy young children

Chest. 2011 Nov;140(5):1325-1331. doi: 10.1378/chest.10-3280. Epub 2011 Apr 28.


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 FEV(1) and fractions thereof (FEV(0.75) and FEV(0.5)) 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 FEV(1)/FVC, FEF(25-75), 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Asian Continental Ancestry Group / statistics & numerical data*
  • Chi-Square Distribution
  • Child, Preschool
  • Cross-Sectional Studies
  • European Continental Ancestry Group / statistics & numerical data*
  • Exhalation
  • Female
  • Humans
  • Linear Models
  • Male
  • Nitric Oxide / metabolism*
  • Respiratory Function Tests / methods*


  • Nitric Oxide