Clinical Phenotype “Obesity-Asthma” as One of the Main Problems of Personalized Pulmonology

Ludmila V. Tribuntceva, Yanina S. Shkatova, Sergey N. Avdeev, Andrey V. Budnevsky, Evgeniy S. Ovsyannikov

 
International Journal of Biomedicine. 2019;9(2):117-120.
DOI: 10.21103/Article9(2)_OA6
Originally published June 15, 2019  

Abstract: 

Background: Asthma is a heterogeneous disease comprising different phenotypes. One of the most common asthma phenotypes is the obesity-asthma phenotype, since obesity affects over a third of the world’s population today. It is important to continue investigating possible underlying mechanisms of the interaction between asthma and obesity. The purpose of this study was to evaluate levels of leptin, adiponectin, neuropeptide Y (NPY), total oxidative damage (TOD), and total antioxidant status (TAS) in patients with asthma and different body weight (BW), and to analyze their association with spirometry parameters.
Materials and Methods: The study included 27 men and 86 women diagnosed with moderate asthma aged from 18 to 75 years (mean age of 57.81±13.05 years). During the study, all asthma patients were divided into 3 groups. Group 1 included 37 patients with normal BW, Group 2 included 38 overweight patients, and Group 3 included 38 patients with obesity. We analyzed complaints, anamnesis data, objective status data, and laboratory (levels of NPY, adiponectin, leptin, total antioxidant status, and total oxidative damage) and instrumental data (spirometry). Two questionnaires were used: Asthma Quality of Life Questionnaire (AQLQ) and Asthma Control Test (АСТ).
 Results: The leptin level was significantly higher in Group 3 compared to Groups 1 and 2 (P=0.0000). The NPY level was significantly lower in Group 1 compared to Groups 2 and 3 (P=0.0000). The TAS value was significantly higher in Group 1 compared to Groups 2 and 3 (P=0.0000) and the TOD value in Group 1 was significantly lower than in Group 3 (P=0.0382). The leptin level positively correlated with BMI and waist circumference, and had an inverse correlation with FEV1 and vital capacity (VC). The adiponectin level had a positive correlation with the Tiffno index, FEF50, and peak expiratory flow (PEF). The NPY level had an inverse correlation with VC, FEV1, FEF25, FVC, Tiffno index, FEF50, and PEF.
Conclusion: The severity of the clinical course of moderate asthma in obese patients is associated with different factors, including oxidative stress and levels of leptin, adiponectin and NPY.

Keywords: 
asthma • body weight • oxidative stress • leptin • adiponectin • neuropeptide Y
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Received April 11, 2019.
Accepted May 9, 2019.
©2019 International Medical Research and Development Corporation.