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Study of Exhaled Nitric Oxide in Subjects with Suspected Obstructive Sleep Apnea: A Pilot Study in Vietnam


Affiliations
1 Bio-Medical Research Center, Lam Dong Medical College, Dalat, Lam Dong 063, Viet Nam
2 Department of Respiratory Physiology, Cochin Hospital, Paris Descartes University, Sorbonne Paris Cite, 75014 Paris, France
3 Department of Technology and Biology, Dalat, Lam Dong 063, Viet Nam
4 Department of Pulmonology, St. Elisabeth Hospital, 5000-5999 Namur, Belgium
5 Pennsylvania State University, 500 University Drive, Hershey, PA 17033, United States
 

Background and Objective: The concentration of exhaled nitric oxide (eNO), reflecting the activity of inducible NO synthase in airway epithelium, has been found to increase in patients with Obstructive Sleep Apnea (OSA). This study aimed to measure eNO concentration in patients with suspected OSA and to correlate different eNO parameters with clinical and sleep apnea characteristics. Methods: In this cross-sectional study, all patients underwent in-lab overnight polysomnography (PSG) and eNO measurement using a method of multiple flow rates before and after PSG (pre- and post-PSG). Results: According to the result of PSG, 82 persons were divided into two groups: control subjects (n = 30; 54 ± 14 years) and patients with OSA defined as Apnea Hypopnea Index (AHI) ≥ 5/hour (n = 52; 53 ± 12 years). Body Mass Index (BMI) and neck and abdomen circumferences of OSA patients were significantly higher than those from control subjects. In OSA group, post-PSG alveolar NO concentration (CANO) (5.3 ± 1.9 ppb) was significantly higher than pre-PSG CANO (4.0 ± 1.7 ppb; P < 0.001). Significant correlations have been found between CANO and AHI (P < 0.001) and between CANO and nadir SpO2 (P < 0.05). The daytime CANO value of more than 4.1 ppb can be used to screen symptomatic subjects for the presence of OSA with a high specificity of 93.3%. Conclusion: Our findings indicate CANO as a surrogate marker for OSA in persons with suggestive symptoms.
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  • Study of Exhaled Nitric Oxide in Subjects with Suspected Obstructive Sleep Apnea: A Pilot Study in Vietnam

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Authors

Sy Duong-Quy
Bio-Medical Research Center, Lam Dong Medical College, Dalat, Lam Dong 063, Viet Nam
Thong Hua-Huy
Department of Respiratory Physiology, Cochin Hospital, Paris Descartes University, Sorbonne Paris Cite, 75014 Paris, France
Huyen-Tran Tran-Mai-Thi
Department of Technology and Biology, Dalat, Lam Dong 063, Viet Nam
Nhat-Nam Le-Dong
Department of Pulmonology, St. Elisabeth Hospital, 5000-5999 Namur, Belgium
Timothy J. Craig
Pennsylvania State University, 500 University Drive, Hershey, PA 17033, United States
Anh-Tuan Dinh-Xuan
Department of Respiratory Physiology, Cochin Hospital, Paris Descartes University, Sorbonne Paris Cite, 75014 Paris, France

Abstract


Background and Objective: The concentration of exhaled nitric oxide (eNO), reflecting the activity of inducible NO synthase in airway epithelium, has been found to increase in patients with Obstructive Sleep Apnea (OSA). This study aimed to measure eNO concentration in patients with suspected OSA and to correlate different eNO parameters with clinical and sleep apnea characteristics. Methods: In this cross-sectional study, all patients underwent in-lab overnight polysomnography (PSG) and eNO measurement using a method of multiple flow rates before and after PSG (pre- and post-PSG). Results: According to the result of PSG, 82 persons were divided into two groups: control subjects (n = 30; 54 ± 14 years) and patients with OSA defined as Apnea Hypopnea Index (AHI) ≥ 5/hour (n = 52; 53 ± 12 years). Body Mass Index (BMI) and neck and abdomen circumferences of OSA patients were significantly higher than those from control subjects. In OSA group, post-PSG alveolar NO concentration (CANO) (5.3 ± 1.9 ppb) was significantly higher than pre-PSG CANO (4.0 ± 1.7 ppb; P < 0.001). Significant correlations have been found between CANO and AHI (P < 0.001) and between CANO and nadir SpO2 (P < 0.05). The daytime CANO value of more than 4.1 ppb can be used to screen symptomatic subjects for the presence of OSA with a high specificity of 93.3%. Conclusion: Our findings indicate CANO as a surrogate marker for OSA in persons with suggestive symptoms.