Exhaled Nitric Oxide as a Surrogate Marker for Obstructive Sleep Apnea Severity Grading: An In-Hospital Population Study

Khue Dang-Thi-Mai,1 Nhat-Nam Le-Dong,2 Vu Le-Thuong,1 Ngoc Tran-Van,1 Sy Duong-Quy3,4 1Department of Respiratory Diseases, Cho Ray Hospital, Ho Chi Minh City, Vietnam; 2Department of Technology, Sunrise, Namur, Belgium; 3Bio-Medical Research Centre, Lam Dong Medical College, Dalat, Vietnam; 4Penn St...

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Autores principales: Dang-Thi-Mai K, Le-Dong NN, Le-Thuong V, Tran-Van N, Duong-Quy S
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Publicado: Dove Medical Press 2021
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spelling oai:doaj.org-article:aab83adcbe1c4b7f830b4666fc2f2a252021-12-02T17:40:58ZExhaled Nitric Oxide as a Surrogate Marker for Obstructive Sleep Apnea Severity Grading: An In-Hospital Population Study1179-1608https://doaj.org/article/aab83adcbe1c4b7f830b4666fc2f2a252021-06-01T00:00:00Zhttps://www.dovepress.com/exhaled-nitric-oxide-as-a-surrogate-marker-for-obstructive-sleep-apnea-peer-reviewed-fulltext-article-NSShttps://doaj.org/toc/1179-1608Khue Dang-Thi-Mai,1 Nhat-Nam Le-Dong,2 Vu Le-Thuong,1 Ngoc Tran-Van,1 Sy Duong-Quy3,4 1Department of Respiratory Diseases, Cho Ray Hospital, Ho Chi Minh City, Vietnam; 2Department of Technology, Sunrise, Namur, Belgium; 3Bio-Medical Research Centre, Lam Dong Medical College, Dalat, Vietnam; 4Penn State Medical College, Hershey Medical Center, Hershey, PA, USACorrespondence: Sy Duong-QuyBio-Medical Research Centre, Lam Dong Medical College, 16 Ngo Quyen, Dalat, VietnamTel +84 918413813Fax +84 2633815000Email sduongquy.jfvp@gmail.comPurpose: Our study aimed to evaluate the relationship between exhaled nitric oxide (eNO) markers and obstructive sleep apnea (OSA) severity and verify the changes in eNO profiles among mild, moderate, and severe OSA subgroups.Methods: This study was a cross-sectional and in-hospital population-based study. We investigated 123 OSA patients (17 mild, 23 moderate and, 83 severe OSA) in the department of respiratory diseases. Studied data included anthropometry, respiratory polygraphy, biological markers, spirometry, and multi-flow eNO measurements. Data analysis implied linear correlation, non-parametric ANOVA, and pair-wise comparison.Results: No significant difference could be found among 3 OSA severity subgroups for FENO at – four sampling flow rates (50– 350 mL/s). The bronchial production rate of NO (J’awNO) was proportionally increased, with median values of 11.2, 33.9, and 36.2 in mild, moderate, and severe OSA, respectively (p=0.010). The alveolar concentration of NO (CANO) changed with a non-linear pattern; it was increased in moderate (6.49) vs mild (7.79) OSA but decreased in severe OSA (5.20, p = 0.015). The only correction that could be established between OSA severity and exhaled nitric oxide markers is through J’AWNO (rho=0.25, p=0.02) and CANO (rho= 0.18, p=0.04). There was no significant correlation between FENO measured at three different flow rates and the OSA severity. We also found a weak but significant correlation between FENO 100 and averaged SpO2 (rho = 0.07, p= 0.03).Conclusion: The present study showed that J’AWNO, which represents eNO derived from the central airway, is proportionally increased in more severe OSA, while eNO from alveolar space, indicated by CANO, was also associated with OSA severity and relatively lower in the most severe OSA patients. In contrast, stand-alone FENO metrics did not show a clear difference among the three severity subgroups.Keywords: exhaled nitric oxide, FENO, J’AWNO, CANO, obstructive sleep apneaDang-Thi-Mai KLe-Dong NNLe-Thuong VTran-Van NDuong-Quy SDove Medical Pressarticleexhaled nitric oxidefenoj’awnocanoobstructive sleep apneaPsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol Volume 13, Pp 763-773 (2021)
institution DOAJ
collection DOAJ
language EN
topic exhaled nitric oxide
feno
j’awno
cano
obstructive sleep apnea
Psychiatry
RC435-571
Neurophysiology and neuropsychology
QP351-495
spellingShingle exhaled nitric oxide
feno
j’awno
cano
obstructive sleep apnea
Psychiatry
RC435-571
Neurophysiology and neuropsychology
QP351-495
Dang-Thi-Mai K
Le-Dong NN
Le-Thuong V
Tran-Van N
Duong-Quy S
Exhaled Nitric Oxide as a Surrogate Marker for Obstructive Sleep Apnea Severity Grading: An In-Hospital Population Study
description Khue Dang-Thi-Mai,1 Nhat-Nam Le-Dong,2 Vu Le-Thuong,1 Ngoc Tran-Van,1 Sy Duong-Quy3,4 1Department of Respiratory Diseases, Cho Ray Hospital, Ho Chi Minh City, Vietnam; 2Department of Technology, Sunrise, Namur, Belgium; 3Bio-Medical Research Centre, Lam Dong Medical College, Dalat, Vietnam; 4Penn State Medical College, Hershey Medical Center, Hershey, PA, USACorrespondence: Sy Duong-QuyBio-Medical Research Centre, Lam Dong Medical College, 16 Ngo Quyen, Dalat, VietnamTel +84 918413813Fax +84 2633815000Email sduongquy.jfvp@gmail.comPurpose: Our study aimed to evaluate the relationship between exhaled nitric oxide (eNO) markers and obstructive sleep apnea (OSA) severity and verify the changes in eNO profiles among mild, moderate, and severe OSA subgroups.Methods: This study was a cross-sectional and in-hospital population-based study. We investigated 123 OSA patients (17 mild, 23 moderate and, 83 severe OSA) in the department of respiratory diseases. Studied data included anthropometry, respiratory polygraphy, biological markers, spirometry, and multi-flow eNO measurements. Data analysis implied linear correlation, non-parametric ANOVA, and pair-wise comparison.Results: No significant difference could be found among 3 OSA severity subgroups for FENO at – four sampling flow rates (50– 350 mL/s). The bronchial production rate of NO (J’awNO) was proportionally increased, with median values of 11.2, 33.9, and 36.2 in mild, moderate, and severe OSA, respectively (p=0.010). The alveolar concentration of NO (CANO) changed with a non-linear pattern; it was increased in moderate (6.49) vs mild (7.79) OSA but decreased in severe OSA (5.20, p = 0.015). The only correction that could be established between OSA severity and exhaled nitric oxide markers is through J’AWNO (rho=0.25, p=0.02) and CANO (rho= 0.18, p=0.04). There was no significant correlation between FENO measured at three different flow rates and the OSA severity. We also found a weak but significant correlation between FENO 100 and averaged SpO2 (rho = 0.07, p= 0.03).Conclusion: The present study showed that J’AWNO, which represents eNO derived from the central airway, is proportionally increased in more severe OSA, while eNO from alveolar space, indicated by CANO, was also associated with OSA severity and relatively lower in the most severe OSA patients. In contrast, stand-alone FENO metrics did not show a clear difference among the three severity subgroups.Keywords: exhaled nitric oxide, FENO, J’AWNO, CANO, obstructive sleep apnea
format article
author Dang-Thi-Mai K
Le-Dong NN
Le-Thuong V
Tran-Van N
Duong-Quy S
author_facet Dang-Thi-Mai K
Le-Dong NN
Le-Thuong V
Tran-Van N
Duong-Quy S
author_sort Dang-Thi-Mai K
title Exhaled Nitric Oxide as a Surrogate Marker for Obstructive Sleep Apnea Severity Grading: An In-Hospital Population Study
title_short Exhaled Nitric Oxide as a Surrogate Marker for Obstructive Sleep Apnea Severity Grading: An In-Hospital Population Study
title_full Exhaled Nitric Oxide as a Surrogate Marker for Obstructive Sleep Apnea Severity Grading: An In-Hospital Population Study
title_fullStr Exhaled Nitric Oxide as a Surrogate Marker for Obstructive Sleep Apnea Severity Grading: An In-Hospital Population Study
title_full_unstemmed Exhaled Nitric Oxide as a Surrogate Marker for Obstructive Sleep Apnea Severity Grading: An In-Hospital Population Study
title_sort exhaled nitric oxide as a surrogate marker for obstructive sleep apnea severity grading: an in-hospital population study
publisher Dove Medical Press
publishDate 2021
url https://doaj.org/article/aab83adcbe1c4b7f830b4666fc2f2a25
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