Peculiarities of Asthma and Insulin Resistance Depending on the Types of Obesity

The purpose of the study was to examine specific clinical and laboratory signs and peculiarities of fatty tissue distribution in patients with bronchial asthma associated with diabetes mellitus, and their effect on respiration function (RF). Material and methods. 78 patients with non-controlled severe-course asthma and diabetes mellitus type 2 were studied. The patients were divided into 2 groups, with android and gynoid obesity types, according to anthropometric signs. Blood chemistry panel was performed: glycated hemoglobin (HbAlc), glucose, triglycerides (TG), total cholesterol (CHOL), low density lipoproteins (LDL), high density lipoproteins (HDL), and insulin resistance index (HOMA-IR). Concentrations of total CHOL, TG, high density lipoproteins (HDL), and low density lipoproteins (LDL) were determined using enzymatic method via photometer Solar PM 2111. Expiratory reserve flow (ERF), forced vital capacity (FVC) and forced expiratory volume for 1st second (FEV1) condition was evaluated based on analysis on a spirograph Spìrokom (Ukraine). Besides, the control level of asthma symptoms was considered using questionnaires ACQ-5. Results and discussion. The android type patients were older and had longer disease history versus the patients with gynoid obesity type. The increase of abdominal fat depots in patients with android type obesity was associated with more pronounced changes in carbohydrate-fat metabolism parameters, which was manifested through elevated glucose, TG, LDL serum values and decreased HDL concentrations. HbAlc and HOMA-IR were reliably increased. Assessment of external respiration function via a spirometer showed that FEV1 %, FVC % in patient groups with gynoid and android obesity types were different as well. In patients with android obesity type, FEV1 and FVC parameters were reliably lower than in the group with gynoid obesity type. Higher degree of ventilation disorders in individuals with high waist circumference – thigh circumference index can be due to fatty tissue central topography type. Conclusions. The obtained data are indicative of various carbohydrate metabolism disorders, dependence of insulin resistance on obesity type, hormonal balance, and RF decrease. Nevertheless, further complex studies, aimed at investigation of clinical peculiarities and hormonal support of pathological processes in patients with the examined pathology are required.