Abstract
BACKGROUND: Although immunoglobulin E (IgE), fractional exhaled nitric oxide (FeNO), and lung function testing are important for asthma diagnosis and assessment, their associations are not fully understood. This study aims to investigate the individual and combined effects of IgE and FeNO on lung function in children with asthma, thereby providing evidence to optimize clinical management. METHODS: Children with asthma admitted to Children’s Hospital Affiliated to Shandong University between June 2019 and July 2023 were enrolled in this study. Demographic data, IgE, FeNO, and lung function parameters were collected. Pearson correlation analysis was used to examine the associations between IgE, FeNO, and lung function. Participants were divided into four groups according to IgE and FeNO levels for comparative analysis of lung function. RESULTS: A total of 1,155 children with asthma were included in the study. Both IgE and FeNO were inversely correlated with large and small airway function parameters (P all < 0.05). IgE and FeNO levels were independently associated with abnormal lung function, with highest risk observed when both biomarkers were elevated: FEV1% (OR = 4.919, 95% CI: 2.734–8.853), FEV1/FVC% (OR = 2.414, 95% CI: 1.602–3.639), MEF25% (OR = 2.077, 95% CI: 1.495–2.886), MEF50% (OR = 1.894, 95% CI: 1.315–2.726), MEF75% (OR = 2.116, 95% CI: 1.260–3.554), and MMEF% (OR = 1.887, 95% CI: 1.319–2.701). CONCLUSION: Both individual and concurrent elevations of IgE and FeNO are associated with abnormal lung function in children with asthma. Therefore, children with elevated levels of IgE and FeNO require particular clinical attention. Integrating IgE and FeNO monitoring with lung function testing may enable more comprehensive asthma assessment and targeted treatment strategies.