The Effect of Adiposity Markers on Fractional Exhaled Nitric Oxide (FeNO) and Pulmonary Function Measurements

Noor Al Khathlan,¹ Ayad Mohammed Salem<sup>2

1</sup>Respiratory Care Department, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; ²Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia

Correspondence: Noor Al Khathlan Email naalkathlan@iau.edu.sa

Background: The effect of increasing body weight on pulmonary function and the fractional exhaled nitric oxide (FeNO) remains controversial and the role of different body compositions in the relationship between obesity with pulmonary function and FeNO is still unrevealed. Thus, we aim to determine the effect of overweight/obesity on lung function and FeNO, focusing on the relationship with different body compositions.
Methods: Eighty-two non-smoker students (20 ± 1.9 years) were divided into two groups: 38 subjects with normal weight (BMI = 18.5– 24.99) and 44 overweight/obese subjects (BMI ≥ 25). Spirometric parameters and FeNO were measured and compared between groups and were correlated with different adiposity markers.
Results: FeNO measurements were elevated in the overweight/obese group [median (IQR) 19.5 (13)] in comparison to the normal weight group [11 (10), p value = 0.017]. A positive correlation was found between FeNO measurements and body mass index (BMI), waist circumference, hip circumference, waist-hip ratio, and visceral fat percentage (all p values < 0.01). The absolute values of forced vital capacity (FVC) forced expiratory volume in the first second (FEV₁), peak expiratory flow (PEF), forced expiratory flow during mid-expiration (FEF_{25– 75%}), and FEV₁/FVC ratio showed no significant differences between groups. However, the percentage of the predicted values of FEV₁ and FVC was significantly higher and the value of percentage predicted FEF_{25– 75%} was reduced significantly in the overweight/obese subjects.
Conclusion: Increase in BMI could significantly increase airway inflammation as measured by FeNO, as well as on distal airway function as determined by the percentage predicted values of FEF_{25– 75%}. A significant correlation was also identified between visceral fat and FeNO measurement.

Keywords: BMI, obesity, FeNO, pulmonary function, body compositions