FeNO may serve as a noninvasive screening tool for gastroesophageal reflux disease in children under 5 years: a retrospective study.
- 1Department of Pediatrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Abstract
Objective
To investigate the correlation between fractional exhaled nitric oxide (FeNO) measurement and pediatric gastroesophageal reflux disease (GERD), explore potential non-invasive screening indicators for pediatric GERD.Methods
A retrospective cohort of 159 children with suspected GERD was enrolled from the Department of Pediatrics, Maternal and Child Health Hospital of Hubei Province between April 2017 and August 2025. Data on 24 h ph and multiple intraluminal impedance monitoring and FeNO were systematically collected and analyzed.Results
Among 159 children, 32 (20.1%) were diagnosed with GERD. In the 101 children under 5 years, 23 (22.8%) were GERD-positive. The median FeNO in the GERD-positive group was significantly higher than that in the GERD-negative group (18.00 vs. 10.00 ppb, P < 0.001). Spearman analysis revealed that FeNO was significantly correlated with the number of reflux cycles (P = 0.012) and pH reflux cycles (P = 0.010). ROC analysis for FeNO predicting GERD yielded an AUC of 0.751 (P = 0.000), with an optimal cutoff of 17.5 ppb, a sensitivity of 52.2%, and a specificity of 87.2%. Multivariate logistic regression further confirmed FeNO as an independent risk factor for GERD in children under 5 years. However, in the 58 children aged ≥5 years, no significant difference in GERD-positive rate was observed between the FeNO₅₀-positive and FeNO₅₀-negative groups (P = 1.00).Conclusions
Elevated FeNO is independently associated with GERD in children under 5 years, showing moderate diagnostic value as a potential non-invasive screening tool, but not in those aged ≥5 years.
Related
- Hiatal Hernia Size and De Novo Gastroesophageal Reflux Disease After Sleeve Gastrectomy: A Single-Center Retrospective Study
- Development and internal validation of a nomogram-based screening tool for concurrent autoimmune hepatitis in children with intestinal diseases: a retrospective cohort study.
- Risk factors for acute gastrointestinal injury after cardiac surgery in underweight children with congenital heart disease: a single-center retrospective study
- The limits of genetic screening: trisomy 21 after euploid preimplantation genetic testing for aneuploidy and negative noninvasive prenatal testing.
- Screening for metabolic dysfunction-associated steatotic liver disease in type 2 diabetes patients using the fibrosis-4 score in medina-retrospective study
BibTeX
@article{wang2026feno,
title = {{FeNO may serve as a noninvasive screening tool for gastroesophageal reflux disease in children under 5 years: a retrospective study.}},
author = {Fang Wang and Ying Cheng and Xiaoqin Zhou and Junhua Shu and Lin Deng and Ruxin Zhang and Yi Gan and Zhongjian Wang},
journal = {Frontiers in pediatrics},
year = {2026},
month = oct,
doi = {10.3389/fped.2026.1925154},
url = {https://europepmc.org/article/MED/42898426},
note = {CC BY},
}
RIS
TY - JOUR
TI - FeNO may serve as a noninvasive screening tool for gastroesophageal reflux disease in children under 5 years: a retrospective study.
AU - Fang Wang
AU - Ying Cheng
AU - Xiaoqin Zhou
AU - Junhua Shu
AU - Lin Deng
AU - Ruxin Zhang
AU - Yi Gan
AU - Zhongjian Wang
PY - 2026
DA - 2026/10/05
JO - Frontiers in pediatrics
DO - 10.3389/fped.2026.1925154
UR - https://europepmc.org/article/MED/42898426
AB - Objective To investigate the correlation between fractional exhaled nitric oxide (FeNO) measurement and pediatric gastroesophageal reflux disease (GERD), explore potential non-invasive screening indicators for pediatric GERD.Methods A retrospective cohort of 159 children with suspected GERD was enrolled from the Department of Pediatrics, Maternal and Child Health Hospital of Hubei Province between April 2017 and August 2025. Data on 24 h ph and multiple intraluminal impedance monitoring and FeNO were systematically collected and analyzed.Results Among 159 children, 32 (20.1%) were diagnosed with GERD. In the 101 children under 5 years, 23 (22.8%) were GERD-positive. The median FeNO in the GERD-positive group was significantly higher than that in the GERD-negative group (18.00 vs. 10.00 ppb, P < 0.001). Spearman analysis revealed that FeNO was significantly correlated with the number of reflux cycles (P = 0.012) and pH reflux cycles (P = 0.010). ROC analysis for FeNO predicting GERD yielded an AUC of 0.751 (P = 0.000), with an optimal cutoff of 17.5 ppb, a sensitivity of 52.2%, and a specificity of 87.2%. Multivariate logistic regression further confirmed FeNO as an independent risk factor for GERD in children under 5 years. However, in the 58 children aged ≥5 years, no significant difference in GERD-positive rate was observed between the FeNO₅₀-positive and FeNO₅₀-negative groups (P = 1.00).Conclusions Elevated FeNO is independently associated with GERD in children under 5 years, showing moderate diagnostic value as a potential non-invasive screening tool, but not in those aged ≥5 years.
SN - 2296-2360
ER -