Peculiaritis of metabolic changes in asthma

Abstract

Introduction. The numbers of patients having asthma (As) and As with metabolic syndrome (MS) keep steadily growing. The aim: revealing of clinical-pathogenetic peculiarities in manifestations of uncontrolled As+MS. Materials and methods. Sixty-five cases, divided into 2 groups: Group I – severe As (n=20), Group 2 – severe As+MS (n=45). The general clinical examination included fasting blood glucose, insulin level, HOMA-IR index, body mass index (BMI), spirometry, levels of ММР-9, МСР-1, IL-8 and IL-12. Results. In Group I, 20 patients (100%) had obstructive respiratory dysfunction. Group II had 13 cases (28.88%) with the restrictive, 15 (33.33%) with the obstructive and 17 (37.77%) with the mixed types. BMI revealed: Group I had the normal mass (BMI averaged 24.62 [22.76; 25.71]; Group II had 21 overweighed cases (46.66%) and 24 (53.33%) with grade 1 obesity, averaging 29.70 [28.35; 31.23]. Correlation analysis in Group II showed significant correlations between: age and WHR (r=0.52, p<0.001) (increase of abdominal fat depots during life), FEV1 and BMI (r=-0.63, р<0.001) (obesity affects pulmonary function). IL-8 and IL-12 levels in Group II were increased, respectively, by 27.86 and 13.18 times versus Group I. A relationship was found between MCP-1 and MMP-9 (r=0.77, р<0.05), Group II revealed direct correlation between MCP-1 and total FEV1 (r=0.53, р<0.05). Conclusions. Overweight and obesity in As+MS deteriorate respiratory function versus the same indices in isolated As. Relationships between proinflammatory cytokines and MMP-9 and MCP-1 prove pathogenetic peculiarities of systemic inflammation and metabolic homeostasis. As and MS can cause their coexistence, facilitating development of mutual aggravation.