CLINICAL AND FUNCTIONAL FEATURES OF CHRONIC OBSTRUCTIVE LUNG DISEASE IN PATIENTS WITH OBESITY

The problem of comorbidity becomes increasingly important in clinical practice. With each year population of patients with combined pathology grows. The amount of diseases per one patient in older age group increases on a regular basis. Comorbidity is understood as existence of two interrelated diseases in one patient. In case of a combined pathology the necessity to study peculiarities of a pathogenetic interaction of diseases, of introduction of new methods of diagnosis, development of new individual approaches to management of each patient, is out of question. In recent decade a significant increase in the incidence of COPD and obesity among the population is noted which suggests a high probability of their combination in one patient. Many scientific works are dedicated to studying peculiarities of the course of COPD in patients with sarcopenia, while much less attention is given to the phenotype of the disease with obesity. Even with the absence of chronic diseases of respiratory organs, obesity leads to formation of respiratory failure. As it follows from practice, the higher the degree of obesity, the more severe respiratory disorders. A special attention is given to abdominal obesity which leads to impairment of the function of lungs to a higher extent. A combination of COPD and obesity is characterized by mutual impairment of diseases, a significant reduction of the quality of life, difficulties of the medico-diagnostic process, increased risk of exacerbations, poor prognosis and high lethality. One of key pathogenetic factors of COPD and obesity is generalized inflammatory reaction. Both diseases are associated with a high level of circulating proinflammatory cytokines in blood plasma: C-reactive protein, fibrinogen, tumor necrosis factor-α, interleukin-8, interleukin-6. It is found in some research that even in patients with a stable course of COPD, the levels of inflammatory biomarkers are increased. A study of clinical and pathogenetic peculiarities of COPD with the underlying obesity will permit to improve the tactics of patients' management, the quality of life, and the effectiveness of rehabilitation measures.