CLINICAL AND FUNCTIONAL FEATURES OF ASTHMA IN COMBINATION WITH METABOLIC SYNDROME

Abstract

Introduction: Asthma is a common chronic non-communicable respiratory disease. One of its clinical phenotypes includes combination with metabolic syndrome. This form of syntrophy results in a more severe course of the disease and a poor prognosis of the disease, often causing severe and poorly controlled form of the asthma. Aim: To study the clinical phenotype of the patients with severe form of asthma combined with metabolic syndrome. Materials and methods: 200 patients with severe and poorly controlled asthma associated with metabolic syndrome were included in this study. Study inclusion criteria were severe and poorly controlled asthma diagnosed according to the GINA international criteria, age over 18 years. Study exclusion criteria were smoking, having chronic obstructive pulmonary disease, active infection, including respiratory system infections, cancer, pregnancy. All the patients underwent clinical and laboratory, instrumental examinations (chest X-ray examination and, according to the indications, multispiral computed tomography of the lungs, spirometry) while hospitalized in the Pulmonology Department. Results: 112 (56%) patients were included in the study group (combined with MS), 88 (44%) patients were included in the control group (without MS). All the patients had poor control of asthma, meanwhile patients with MS (study group) were indicated with significantly worse asthma control (AST-test Me was 11), differences were significant (р<0,001). According to spirometry it was indicated that study group had lower level of FVC and FEV1. It was also stated that having hypereosinophilia was associated with lower FEV1 (OR 0.82) and PEF after bronchodilatatory test (OR 0.988). Conclusion: The identified during the study changes in external respiratory function in patients with severe asthma in syntrophy with MS, as determined by a decrease in EFV1, FVC and the ratio of FEV1 to FVC, should be taken into account in the treatment of this phenotype of asthma. An integrated approach based on the use of all pharmacological options in combination with BMI correction is likely to be a factor in improving lung function, thereby increasing the degree of asthma symptom control.