Carbohydrate Metabolism Status in Patients with Bronchial Asthma Depending on the Character of Glucocorticosteroid Baseline Therapy

The aim of the investigation is to study carbohydrate metabolic disorders and reveal the risk factors of the disorders in patients with bronchial asthma in various baseline glucocorticosteroid (GCS) therapy.

Materials and Methods. 174 patients with bronchial asthma were studied. The patients of the 1st group (n=58) had no baseline therapy, the 2nd group (n=85) had baseline therapy of inhalation GCS, and the 3rd group (n=31) received tableted GCS. All the patients underwent pulmonary function test, and carbohydrate metabolism indexes.

Results. Diabetes mellitus and other carbohydrate metabolic disorders in patients with bronchial asthma occur more frequently than in general population. The main risk factors of carbohydrate metabolic disorders are GCS baseline therapy, as well as long duration of the disease. Baseline therapy of high doses of inhalation GCS also contributes to carbohydrate metabolic disorders development, and foremost, hyperinsulinemia, insulin resistance and prediabetes.

1. Macharadze D.Sh. Lecasiy Vrach 2010; 6: 11–15.
2. Nagornyy A.B. Osobennosti narusheniya uglevodnogo obmena u bol’nykh bronkhial’noy astmoy. Avtoref. dis. … kand. med. nauk [The characteristics of carbohydrate metabolic imbalance in patients with bronchial asthma. Abstract of Dissertation for the degree of Candidate of Medical Science]Moscow; 2004; 111 p.
3. Yakovleva O.A., Zhamba A.O., Mazur Yu.V. Racion Farmakoter 20081(06): 64–67.
4. Uryas'ev O.M., Panfilov Yu.A. Mezdunar Endokrinol Z 2008; 3(15): 15–25.
5. Litonjua A.A., Lazarus R., Sparrow D. et al. Lung function in type 2 diabetes: the Normative Aging Study. Respir Med 2005; 99(12): 1583–1590.
6. Poulain M., Doucet M., Major G.C. et al. The effect of obesity on chronic respiratory diseases: pathophysiology and therapeutic strategies. CMAJ 2006; 174(9): 1293–1299.
7. Varner A.E. An immunologic mechanism for the association between obesity and asthma. Arch Intern Med 2000; 160(15): 2395–2396.
8. Global'naya strategiya lecheniya i profilaktiki bronkhial'noy astmy. Pod red. Chuchalina A.G. [Global strategy of bronchial asthma treatment and prophylaxis]. Moscow: Izdatel'skiy dom “Atmosfera”, 2007; 104 p.
9. Global'naya strategiya lecheniya i profilaktiki bronkhial'noy astmy. Pod red. Chuchalina A.G. [Global strategy of bronchial asthma treatment and prophylaxis]. Moscow: Izdatel'skiy dom “Atmosfera”, 2002.
10. Smolenov I.V. Atmos, Pulmonol Allergol 2002; 3(6): 71–75.
11. Voznesenskiy N.A. Ross Med Z 2008; 16(2): 65–68.
12. Mitchenko E.I., Korpachev V.V. et al. Mezhdunarodnyy endokrinologicheskiy zhurnal 2008; 3(15): 44–48.
13. Esposito K., Giugliano D., Nappo F. et al. Regression of carotid atherosclerosis by control of postprandial hyperglycemia in type 2 diabetes mellitus. Circulation 2004; 110(2): 214–219.
14. Prakticheskaya endokrinologiya [Practical Endocrinology]. Pod red. G.A. Mel’nichenko. Moscow: Prakticheskaya meditsina; 2009; 352 p.
15. Dedov I.I, Mel’nichenko G.A., Fadeev V.F. Endokrinologiya [Endocrinology]. Moscow: GEOTAR-Media; 2007; 432 p.

Vakhlamov V.А., Varvarina G.N., Eriskina А.А., Orlova Yu.А. Carbohydrate Metabolism Status in Patients with Bronchial Asthma Depending on the Character of Glucocorticosteroid Baseline Therapy. Sovremennye tehnologii v medicine 2012; (1): 129