Slaba O. Peculiarities of the course of bronchial asthma in combination with obesity of varying degrees

The thesis is devoted to studying the impact of obesity on the course of bronchial asthma (BA). A precise clinical examination of 104 hospitalized patients with persistent asthma (the main group), along with 30 practically healthy persons comparable by age and sex (the control group) was performed. It was found that patients with overweight and obesity significantly more frequently have severe respiratory failure, lung emphysema and pneumofibrosis. Allergic component of BA significantly more commonly was observed among patients with normal body weight and overweight than in obese persons. Asthma in combination with obesity was characterized by activation of inflammatory syndrome according to white blood cell count, erythrocyte sedimentation rate, nuclear index of intoxication, and C-reactive protein (CRP). Besides, obese persons were found to have significantly lower both flow and volume parameters during lung function testing. It was established that hyperleptinemia was associated with more severe disease, characterized by neutrophilic leukocytosis, more pronounced obstructive syndrome, and frequent concomitant diseases. All patients with low blood adiponectin levels were diagnosed to have complicated asthma. Activation of inflammatory syndrome (basing on CRP levels) was associated with more severe disease, hypoadiponectinemia, and maladaptation. Decreased index of adaptation and presence of stress reaction in asthmatic patients were associated with elongation of terms of in-patient treatment, arterial hypertension, and activation of inflammatory syndrome. Analysis of the adaptation potential showed that obese patients with BA significantly more often demonstrated failure of adaptation that was accompanied by activation of inflammation and higher serum leptin levels. Industry - medicine.