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

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 (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 (blood 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=0.000). The NPY level was significantly lower in Group 1 compared to Groups 2 and 3 (P=0.000). The TAS value was significantly higher in Group 1 compared to Groups 2 and 3 (P=0.000) and the TOD value in Group 1 was significantly lower than in Group 3 (P=0.038).The leptin level positively correlated with BMI and waist circumference, and had an inverse correlation with FEV 1 and vital capacity (VC). The adiponectin level had a positive correlation with the Tiffno index, FEF 50 , and peak expiratory flow (PEF). The NPY level had an inverse correlation with VC, FEV 1 , FEF 25 , FVC, Tiffno index, FEF 50 , 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.