GENDER PECULIARITIES OF BRONCHIAL ASTHMA COURSE IN PATIENTS WITH BODY MASS DIFFERENCE

Abstract

Bronchial asthma is among the most common diseases of the respiratory system. Increased incidence of bronchial asthma can be associated with obesity that is more common nowadays. Fatty tissue plays a special role in the formation of systemic inflammation, which differs depending on gender. The aim of the research was to compare peculiarities of clinical course and spirometry indices in patients with bronchial asthma and body mass difference depending on gender. A complete clinical examination of 104 patients with persistent BA in an inpatient department has been performed. Depending on body mass index, all patients were divided into three subgroups: the first one included 36 patients with normal body mass, the second subgroup – 34 overweight patients, and the third subgroup – 34 patients with obesity. In each subgroup, most patients suffered from persistent BA of moderate degree, mild course was usually observed in overweight patients. Severe course was more common in patients with obesity and normal body mass. To detect gender peculiarities, we analyzed data of case histories and peculiarities of clinical course. It was revealed that 91.6% of women with obesity had reported onset of the disease in middle age, and 40% of men had suffered since childhood. In the subgroup with normal body mass, 59.1% of men and 57.1% of women suffered less than 10 years. Thus, the disease progressed more rapidly in obese women, while there was not gender difference in disease duration under conditions of normal body mass. Complicated course was much more common in women. However, men more often suffered from type 2 diabetes mellitus. Gender differences in the spirometry indices were analyzed separately in women and men depending on body mass. In obese women, of all spirometry indices, only MEF75 decreased. It proves that more marked obstructive changes are observed at the level of tiny branches of the bronchial tree in obese women. In overweight men, FVC, IVC, FEV1 and PEF were lower than in the subgroup with normal mass. These indices were also significantly lower in the subgroup of patients with obesity. Thus, in men, increase in body mass has more influence on speed and volume of air in spirometry indices. To perform thorough gender analysis, we compared spirometry indices in overweight men and women and obese individuals together and revealed some peculiarities. In men, the majority of spirometry indices are significantly lower than in women, indicating more severe course of the disease. Among them, all indices confirm restrictive changes in the lungs and FEV1 is the main marker of broncho-obstructive syndrome. Besides, more manifested obstructive changes were observed in men both at the level of the main, secondary and tertiary bronchi. Conclusion. Excessive body mass in men has more manifested influence on speed and volume of air in spirometry indices. Such marked changes in respiratory function can be explained by the fact that abdominal obesity is more common in men, which contributes to the decrease in volume and speed indices due to restrictive diaphragmatic excursion and, as a result, deterioration of broncho-obstructive syndrome.

Keywords

• bronchial asthma
• obesity
• gender peculiarities
• pulmonary function tests