In comparison to CC and CG genotypes, the GG genotype is associated with pronouced dyspnea, decreased excercise tolerance, increased total cholesterol, triglycerides, lowdensity lipoprotein cholesterol, leptin, resistin, tumor necrosis factor alpha and surfactant protein D levels, body mass index, body fat percentage and visceral fat level, and the lowest muscle mass. Furthermore, a negative correlation between body fat percentage and forced expiratory volume in one second/forced vital capacity, visceral fat level and forced expiratory volume in one second/forced vital capacity, serum leptin levels and the COPD Assessment Test score and the BODE index, in addition to a positive correlation between serum leptin levels and the COPD Assessment Test score and the BODE index, as well as a negative correlation in the pair C reactive protein – 6minute walk test, tumor necrosis factor alpha – COPD Assessment Test score, dyspnea and the BODE index.
The practical significance of the results. It has been proposed to use the Asthma Control Questionnaire – 5, the COPD Assessment Test, the St. George Hospital Respiratory Questionnaire to monitor the disease and evaluate the health related quality of life, in addition to measurements of bioimpedancemetry, blood lipid spectrum, adipokine profile, systemic inflammation, endothelial function, pro and antioxidants system in asthmaCOPD overlap patients with obesity.
It is suggested that the polymorphism of the glucocorticoid receptor gene should be determined in asthmaCOPD overlap patients with obesity before the start of basic therapy with inhaled corticosteroids and longacting β2agonists in order to access the risk of a negative response to treatment.
It is reccomended to include erythromycin at a dose of 200 mg three times a day, erdosteine at a dose of 300 mg twice a day and a complex of rehabilitation programs for 3 months to the basic therapy of asthmaCOPD overlap patients with obesity in order to reduce dyspnea, cough and sputum production, decrease the leukocytes, neutrophils and eosinophils levels in peripheral blood and sputum, increase exercise capacity and muscle mass, reduce the degree of bronchial obstruction, body mass index, body fat percentage, severity of systemic inflammation and oxidative stress, as well as the severity of the disease, while simultaneously improving the prognosis of the disease and health related quality of life.
Scientific developments have been implemented in the practice of medical and preventive establishments of Ukraine, which is confirmed by the relevant acts of implementation.
