Pulmonary function and risk factors in pediatric chest tightness variant asthma: a case-control study

To investigate the pulmonary function characteristics and risk factors for pediatric chest tightness variant asthma (CTVA).

A retrospective case-control study was conducted. Clinical data of 39 children diagnosed with CTVA in our outpatient department from February 2022 to February 2024 were analyzed. Fifty healthy children undergoing physical examinations during the same period were enrolled as controls. All participants underwent fractional exhaled nitric oxide (FeNO) measurement and pulmonary ventilation function tests at initial diagnosis or physical examination. FeNO levels and pulmonary function parameters were compared between groups. Baseline demographic and clinical data were recorded. Univariate logistic regression analyses were performed to explore factors associated with pediatric CTVA. Due to the limited sample size (39 cases) and an event-per-variable ratio below the recommended minimum of 10:1 for reliable multivariable modeling, multivariate analysis was not performed.

FeNO levels were significantly higher in the CTVA group than in the healthy control group (p = 0.016). FEV1/FVC, PEF, FEF25, FEF50, and FEF75 were significantly lower in the CTVA group (all p < 0.05), whereas FEV1, FVC, and MMEF showed no significant differences (p > 0.05). Significant intergroup differences were observed for obesity, inhalant allergen sensitization, allergic rhinitis, atopic dermatitis, history of recurrent respiratory infections, and family history of allergic diseases (all p < 0.05). Univariate logistic regression analysis confirmed these six factors as significantly associated with pediatric CTVA (all p < 0.05).ntified these six factors as potential independent risk factors for pediatric CTVA (all p < 0.05).

Children with CTVA have higher FeNO levels and lower FEV1/FVC, PEF, FEF25, FEF50, and FEF75 compared to healthy peers. Obesity, inhalant allergens, allergic rhinitis, atopic dermatitis, recurrent respiratory infections, and family history of allergic diseases showed significant univariate associations with pediatric CTVA in this exploratory cohort. Combined assessment of FeNO and small airway parameters may aid in the diagnostic evaluation of CTVA, although further diagnostic accuracy studies are needed.