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ASSESSMENT OF SPIROMETRIC PARAMETERS, FENO LEVELS, AND ASTHMA CONTROL IN UNTREATED ASTHMA PATIENTS AT THE UNIVERSITY MEDICAL CENTER HO CHI MINH CITY
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Abstract
Background: Asthma control, spirometric parameters, and fractional exhaled nitric oxide (FeNO) are important components in the diagnosis and management of asthma. In Viet Nam, available data remains limited, inconsistent, and particularly scarce among untreated asthma patients. Objective: To describe spirometric characteristics, FeNO levels, and asthma control among stable, untreated, or ICS-withdrawn (≥4 weeks) outpatient asthma patients at the University Medical Center Ho Chi Minh City. Methods: A prospective cross-sectional study was conducted at the University Medical Center Ho Chi Minh City among adult asthma patients (≥18 years) who underwent spirometry, FeNO measurement, and assessment using the Asthma Control Test (ACT). Results: 145 patients met inclusion criteria (male 42.1%; mean age 44.19 ± 15.39 years; BMI = 23.74 ± 3.53 kg/m2). The mean ACT score was 19.26 ± 3.36, and mean FeNO was 27.63 ± 18.85 ppb.
Pre-bronchodilator spirometry (% predicted): FVC 89.74 ± 16.97; FEV1 78.52 ± 19.20; FEV1/FVC = 0.73 ± 0.10; FEF25-75 57.68 ± 24.27. Pre-bronchodilator obstructive syndrome: 74% no obstruction, 15.2% dysanapsis, 14.5% mild obstruction, 13.1% moderate, and 6.2% severe. ACT classification: well controlled = 51.7%, partly controlled = 36.6%, poorly controlled = 11.7%. FeNO classification: 52.4% low, 36.6% moderate, 11.0% high. FeNO levels increased with poorer asthma control (ACT 5–15: 46.89 ± 11.85 ppb; 16–19: 30.93 ± 23.63; 20–25: 20.93 ± 11.41), while ACT scores decreased across FeNO categories (<25 ppb: 20.61 ± 2.44; 25–50 ppb: 18.26 ± 3.53; ≥50 ppb: 16.13 ± 3.52). Pre-bronchodilator FEV1 was lower in poorly controlled groups and those with FeNO ≥ 50 ppb. Differences in FeNO among ACT control groups and ACT scores among FeNO categories were statistically significant (p < 0.001). Pre- bronchodilator FEV1/SVC and FEV1/FVC had statistical significance across ACT and FeNO groups. Conclusion: Among untreated or ICS-withdrawn asthma outpatients, ACT scores were generally high, spirometry had normal VC but mildly reduced FEV1, and FeNO levels were moderately increase. FeNO levels differed significantly among ACT control groups, and ACT scores differed across FeNO categories
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Keywords
Asthma; FeNO; Spirometry; FEV1; ACT; Asthma control level.
References
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