Vocal acoustic parameters as biomarkers to detect asthma and its association with respiratory symptoms and comorbidities: a cross-sectional study

Abstract Introduction : Asthma is an obstructive airway disease with a high prevalence worldwide. Vocal acoustic parameters have been investigated as biomarkers in several clinical conditions; however, their use in asthma remains poorly known. Aim : To investigate whether vocal acoustic parameters can be used as biomarkers to detect asthma and to evaluate their association with respiratory symptoms and comorbidities. Methods: This cross-sectional study included 270 individuals: 180 with moderate-to-severe controlled asthma (CA) or non-controlled asthma (NCA) and 90 healthy controls (HC). Participants with asthma were classified as having CA or NCA using the Asthma Control Questionnaire (ACQ). The HC group was matched for age, sex, and body mass index (BMI). Voice samples consisted of a sustained vowel recorded on a smartphone using the SPIRA® application. Acoustic outcomes were obtained using Praat software, including fundamental frequency (F0), standard deviation fundamental frequency (SDf0), jitter, shimmer, number of voice breaks, and Harmonics-to-Noise Ratio (HNR). All analyses were stratified by sex. Results: No anthropometric differences were observed in either sex. Among females, both asthma groups showed higher shimmer and voice breaks and lower HNR values, but only NCA showed higher SDf0 and jitter (p<0.05). Among males, both asthma groups showed higher shimmer values, while HNR was lower only in CA compared with HC (p<0.05). No acoustic parameters differed between CA and NCA in either sex. Significant linear associations were observed between acoustic parameters, respiratory symptoms, and comorbidities in females. Conclusion: Vocal acoustic parameters discriminated asthma from controls but did not differentiate between asthma. These results suggest that these parameters can be used as biomarkers for detecting asthma.