Peculiarities of asthma and insulin resistance depending on the types of obesity

Abstract

The purpose of the study was to examine specific clinical and laboratory signs and peculiarities of fatty tissue distribution in patients with bronchial asthma associated with diabetes mellitus, and their effect on respiration function (RF).

Material and methods. 78 patients with non-controlled severe-course asthma and diabetes melli-tus type 2 were studied. The patients were divided into 2 groups, with android and gynoid obesity types, according to anthropometric signs. Blood chemistry panel was performed: glycated hemoglobin (HbAlc), glucose, triglycerides (TG), total cholesterol (CHOL), low density lipoproteins (LDL), high density lipopro-teins (HDL), and insulin resistance index (HOMA-IR). Concentrations of total CHOL, TG, high density lipo-proteins (HDL), and low density lipoproteins (LDL) were determined using enzymatic method via pho-tometer Solar PM 2111. Expiratory reserve flow (ERF), forced vital capacity (FVC) and forced expira-tory volume for 1st second (FEV1) condition was evalu-ated based on analysis on a spirograph Spìrokom (Ukraine). Besides, the control level of asthma symp-toms was considered using questionnaires ACQ-5.

Results and discussion. The android type patients were older and had longer disease history versus the patients with gynoid obesity type. The increase of ab-dominal fat depots in patients with android type obe-sity was associated with more pronounced changes in carbohydrate-fat metabolism parameters, which was manifested through elevated glucose, TG, LDL serum values and decreased HDL concentrations. HbAlc and HOMA-IR were reliably increased. Assessment of external respiration function via a spirometer showed that FEV1 %, FVC % in patient groups with gynoid and android obesity types were different as well. In pa-tients with android obesity type, FEV1 and FVC pa-rameters were reliably lower than in the group with gynoid obesity type. Higher degree of ventilation dis-orders in individuals with high waist circumference – thigh circumference index can be due to fatty tissue central topography type.

Conclusions. The obtained data are indicative of various carbohydrate metabolism disorders, dependence of insulin resistance on obesity type, hormonal balance, and RF decrease. Nevertheless, further complex studies, aimed at investigation of clinical peculi-arities and hormonal support of pathological processes in patients with the examined pathology are required.