Peculiarities of the association of bronchial asthma with obesity depending on the time of asthma debut and the possibilities of cardiovascular risk prediction in this group of patients

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Abstract

Bronchial asthma (BA) is a global medical and social problem. The incidence of asthma and obesity worldwide is steadily increasing. The aim of the study was to evaluate the clinical, pathophysiological and molecular features of various obesity phenotypes in patients with BA in order to optimize anti-asthma therapy and early diagnosis of cardiovascular complications. Material and methods. 150 asthma patients were examined. They were divided into 3 groups depending on the ratio of the onset time of asthma to obesity: «Obesity + BA» (Group 1), «BA + obesity» (Group 2), «BA without obesity» (BMI 18.5-25 kg/m2, Group 3). The comparison group consisted of 30 relatively healthy volunteers. Following parameters were studied: the degree of obesity and asthma, respiratory function parameters, lipid profile, indicators of insulin metabolism, insulin resistance and levels of adipokines in peripheral blood, level of NO in exhaled air (FeNO), cellular composition of induced sputum, values of left ventricular hypertrophy (LVH), thickness of the intima-media complex of the common carotid artery (CCA TIM). Results and conclusion. In the «Obesity + BA» group, a severe course of the disease was recorded more often (33%), which correlated with a low level of control, impaired bronchial patency, and pulmonary hyperinflation formation. In the «Obesity + BA» group, dyslipidemia, insulin resistance, and adipokines imbalance were more evident. FeNO was comparatively lower in the «Obesity + BA» group. When assessing the cellular composition of induced sputum in the Obesity + BA group, neutrophilic biotype was recorded in 39% of patients, and a small granulocytic BA biotype was recorded in 43%. In the group of patients «Obesity + BA», the highest values of LVH and CCA TIM were recorded. Identification of different phenotypes of BA associated with obesity is necessary due to the need to verify patients with high cardiovascular risks.

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About the authors

Dmitry A. Anikin

Professor V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University of the Ministry of Healthcare of Russia; Regional Clinical Hospital, Krasnoyarsk

Email: anikin27111994@mail.ru
postgraduate student of the Department of hospital therapy and immunology with the course of postgraduate education

Irina A. Solovieva

Professor V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University of the Ministry of Healthcare of Russia; Regional Clinical Hospital, Krasnoyarsk

Email: acad-prorector@krasgmu.ru
Dr. med. habil., associate professor, professor of the Department of hospital therapy and immunology with a postgraduate education course

Irina V. Demko

Professor V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University of the Ministry of Healthcare of Russia; Regional Clinical Hospital, Krasnoyarsk

Email: demko64@mail.ru
Dr. med. habil., professor, head of the Department of hospital therapy and immunology with a postgraduate education course

Elena A. Sobko

Professor V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University of the Ministry of Healthcare of Russia; Regional Clinical Hospital, Krasnoyarsk

Email: sobko29@mail.ru
Dr. med. habil., professor of the Department of hospital therapy and immunology with a postgraduate education course

Natalya V. Gordeeva

Professor V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University of the Ministry of Healthcare of Russia; Regional Clinical Hospital, Krasnoyarsk

Email: natagorday@yandex.ru
PhD in Medicine, associate professor of the Department of hospital therapy and immunology with a postgraduate education course

Angelina Yu. Kraposhina

Professor V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University of the Ministry of Healthcare of Russia; Regional Clinical Hospital, Krasnoyarsk

Email: angelina-maria@inbox.ru
PhD in Medicine, associate professor of the Department of hospital therapy and immunology with a postgraduate education course

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