The Role of Modern Methods of Examination in Assessing the Effect of Smoking on the Course of Bronchial Asthma and Development of Comorbid Metabolic Pathology

The aim of the investigation was to demonstrate the feasibilities of using up-to-date methods of examination for assessing the effect of smoking on the course of bronchial asthma (BA) and development of comorbid metabolic pathology.

Materials and Methods. 201 patients with noncontrolled BA were investigated. Group 1 comprised 152 nonsmoking patients, group 2 included 18 smokers, group 3 consisted of 31 heavy smokers. Along with the general clinical methods of examination, external respiration function with evaluation of forced life capacity, forced expiratory volume in 1 second, and Tiffeneau index were investigated. To diagnose obesity, a bioelectrical impedance analysis was used, body mass index was determined, and waist measurements were performed. To study the carbohydrate metabolism, the level of glycated hemoglobin (HbA1c), immunoreactive insulin, and C-peptide were estimated.

Results. Waist measurements, bioelectrical impedance analysis, determination HbA1c, immunoreactive insulin, and C-peptide levels are established to play a great role in the diagnosis of comorbid endocrine pathology in BA. The severity of the disease in BA patients is aggravated by visceral obesity and diabetes mellitus, and cigarette smoking is an essential risk factor of their development. Long-term heavy smokers with BA are characterized by the addition of chronic obstructive pulmonary disease and the development of overlap syndrome with an extremely severe course.

1. Astaf’eva N.G., Gamova I.V., Udovichenko E.N., Perfilova I.A. Obesity and bronchial asthma (part 1). Lechashchiy vrach 2014; 4: 8.
2. Global’naya strategiya diagnostiki, lecheniya i profilaktiki khronicheskoy obstruktivnoy bolezni legkikh (peresmotr 2011 g.) [Global strategy of diagnosis, treatment and prevention of chronic obstructive pulmonary disease (updated 2011)]. Pod red. Belevskogo A.S. [Belevskiy A.S. (editor)]. Moscow: Rossiyskoe respiratornoe obshchestvo; 2012.
3. Budnevskiy A.V., Chernov A.V., Ermolova A.V., Tribuntseva L.V. Co-morbidity of bronchial asthma and metabolic syndrome: possibilities to achieve asthma control. Russian Pulmonology 2014; 5: 39–45.
4. Astaf’eva N.G., Gamova I.V., Udovichenko E.N., Perfilova I.A. Obesity and bronchial asthma (part 2). Lechashchiy vrach 2014; 5: 100.
5. Mineev V.N., Lalaeva T.M., Vasilyeva T.S., Trofimov V.I. Phenotype of bronchial asthma with obesity. Russian Pulmonology 2012; 2: 102–107.
6. Sysoeva M.S., Solovievа A.V., Nikiforov A.А., Rakita D.R. Influence of metabolic syndrome on the course of bronchial asthma. Rossiyskiy mediko-biologicheskiy vestnik im. akademika I.P. Pavlova 2011; 4: 93–98.
7. Uryas’ev O.M., Panfilov Yu.A. Bronchial asthma and metabolic syndrome: some aspects of comorbidity. Mezhdunarodnyy endokrinologicheskiy zhurnal 2008; 3(15): 15–25.
8. Ermolova A.V., Budnevskiy A.V., Drobysheva E.S. Bronchial asthma and metabolic syndrome: clinical-pathological relations. Molodoy uchenyy 2014; 6: 291–294.
9. Beyther D.A., Sutherland E.R. Over weight, obesity and incident asthma: a meta-analysis of prospective epidemiologic studies. Am J Resp Crit Care Med 2007; 175: 661–667, https://doi.org/10.1164/rccm.200611-1717OC.
10. Yeh K.H., Skowronski M.E., Coreno A.J., Seitz R.E., Villalba K.D., Dickey-White H., McFadden E.R. Impact of obesity on the severity and therapeutic responsiveness of acute episodes of asthma. J Asthma 2011; 8(6): 546–552, https://doi.org/10.3109/02770903.2011.581733.
11. Tsibulkina V.N., Tsibulkin N.A. Asthma and obesity: coincidence or pattern? Prakticheskaya meditsina 2011; 6(54): 36–41.
12. Shore S.A. Obesity and asthma: possible mechanisms. J Allergy Clin Immunol 2008; 121(5): 1087–1093, https://doi.org/10.1016/j.jaci.2008.03.004.
13. Saint-Pierre P., Bourdin A., Chanez P., Daures J.-P., Godard P. Are overweight asthmatics more difficult to control? Allergy 2006; 61(1): 79–84, https://doi.org/10.1111/j.1398-9995.2005.00953.x.
14. Global’naya strategiya lecheniya i profilaktiki bronkhial’noy astmy (peresmotr 2014 g.) [Global strategy for asthma management and prevention (updated 2014)]. Pod red. Belevskogo A.S. [Belevskiy A.S. (editor)]. Moscow: Rossiyskoe respiratornoe obshchestvo; 2015.
15. Belevskiy A.S. Syndrome of bronchial asthma and chronic obstructive pulmonary disease overlap (based on the joint document of the GINA and GOLD working groups of experts). Prakticheskaya pul'monologiya 2014; 2: 12–19.
16. Trofimov V., Mironova Zh., Belash V. Overlap syndrome of chronic obstructive pulmonary disease–asthma. Vrach 2013; 2: 20–21.
17. Proekt rekomendatsiy ekspertov Rossiyskogo kardiologicheskogo obshchestva po diagnostike i lecheniyu metabolicheskogo sindroma (3-y peresmotr) [Draft recommendations of experts from the Russian Society of Cardiology for the diagnostics and treatment of metabolic syndrome (3rd updated)]. Moscow; 2013; 103 p.
18. Likhonosova A.P., Likhonosov N.P., Kuznetsova O.G. Analysis of methods for determining the level of glycosylated hemoglobin as used in health care facilities in Saint Petersburg. Mezhdunarodnyy endokrinologicheskiy zhurnal 2010; 6(30): 23–27.

Vakhlamov V.A. The Role of Modern Methods of Examination in Assessing the Effect of Smoking on the Course of Bronchial Asthma and Development of Comorbid Metabolic Pathology. Sovremennye tehnologii v medicine 2017; 9(2): 99, https://doi.org/10.17691/stm2017.9.2.12