Asia Pac Allergy.  2020 Jan;10(1):e7. 10.5415/apallergy.2020.10.e7.

Fractional exhaled nitric oxide and forced expiratory volume in 1 second/forced vital capacity have predictive value of asthma exacerbation in Korean school children

  • 1Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.
  • 2Department of Pediatrics, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.
  • 3Oksan and Gangnae Elementary School, Chungbuk, Cheongju, Korea.


The incidence of asthma exacerbation (AE) and the predictive value of spirometry and fractional exhaled nitric oxide (FeNO) in school children have not been evaluated.
We sought to evaluate the efficacy of spirometry measurement and FeNO monitoring for predicting AE in school children in the Cheongju area in Korea.
With parental agreement, we studied 170 students aged 7-12 years. Children were evaluated by an asthma specialist using baseline spirometry, skin prick test, seasonal FeNO measurement, and asthma control test. The study participants underwent a physical examination and their medical history was also evaluated by the specialist. They were assessed for asthma control status during regular doctor visits for 1 year.
In total, 160 children (94.1%) completed follow-up and FeNO monitoring. Of which, 26 children (16.3%) had AE. AE was associated with male children and children with allergic rhinitis (p < 0.05). While, children with AE tended to have higher FeNO than those without AE, no significant difference was found. The maximum value of FeNO ≥35 ppb was associated with AE (p < 0.05). Children with AE had a significantly decreased baseline forced expiratory volume in 1 second/forced vital capacity (FEV₁/FVC), %predicted, forced expiratory flow at 25%-75% of FVC (FEF(25%-75%)). FEV₁/FVC < 80% was associated with AE in children regardless of inhalant allergen sensitization (all p < 0.05).
Baseline spirometry had a predictive value of AE in school children. Sensitive spirometric parameters such as FEV₁/FVC and FEF(25%-75%) can be used as prognostic factors to predict future childhood AE. FeNO value ≥ 35 ppb during monitoring was associated with AE in school children.


Asthma; Exacerbation; Child; Exhaled nitric oxide; Spirometry

MeSH Terms

Follow-Up Studies
Forced Expiratory Volume*
Nitric Oxide*
Physical Examination
Rhinitis, Allergic
Vital Capacity*
Nitric Oxide

Cited by  1 articles

The 10th Anniversary of Asia Pacific Allergy
Yoon-Seok Chang
Asia Pac Allergy. 2020;10(1):.    doi: 10.5415/apallergy.2020.10.e10.



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