Asthma was associated with insulin resistance and a systemic inflammatory response possibly mediated by adipokines, with leptin levels standing out among the participants with excess weight.
Objective:To evaluate the clinical evolution and the association between nutritional status
and severity of asthma in children and adolescents enrolled in Primary Health
Care.Methods:A retrospective cohort study of 219 asthmatic patients (3-17 years old) enrolled
in Primary Care Services (PCSs) in Embu das Artes (SP), from 2007 to 2011.
Secondary data: gender, age, diagnosis of asthma severity, other atopic diseases,
family history of atopy, and body mass index. To evaluate the clinical outcome of
asthma, data were collected on number of asthma exacerbations, number of emergency
room consultations and doses of inhaled corticosteroids at follow-up visits in the
6th and 12th months. The statistical analysis included chi-square and Kappa
agreement index, with 5% set as the significance level.Results:50.5% of patients started wheezing before the age of 2 years, 99.5% had allergic
rhinitis and 65.2% had a positive family history of atopy. Regarding severity,
intermittent asthma was more frequent (51.6%) and, in relation to nutritional
status, 65.8% of patients had normal weight. There was no association between
nutritional status and asthma severity (p=0.409). After 1 year of
follow-up, 25.2% of patients showed reduction in exacerbations and emergency room
consultations, and 16.2% reduced the amount of inhaled corticosteroids.Conclusions:The monitoring of asthmatic patients in Primary Care Services showed improvement
in clinical outcome, with a decreased number of exacerbations, emergency room
consultations and doses of inhaled corticosteroids. No association between
nutritional status and asthma severity was observed in this study.
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