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Rationale for the Use of New Methods of Investigation of Metabolic Syndrome in the Diagnosis and Treatment of Patients with Broncho-Obstructive Diseases

Rationale for the Use of New Methods of Investigation of Metabolic Syndrome in the Diagnosis and Treatment of Patients with Broncho-Obstructive Diseases

Vakhlamov V.A., Tyurikova A.V.
Key words: metabolic syndrome; bronchial asthma; chronic obstructive pulmonary disease.
2015, volume 7, issue 4, page 127.

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The aim of the investigation was to evaluate the need for further research into features of the morbidity and the course of metabolic syndrome among patients with bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD).

Materials and Methods. We examined 235 patients with BA and 103 patients with COPD. To evaluate their nutritional status we identified the body mass index, waist circumference (WC), the index of “waist circumference/height” (WC/height), and the percentages of adipose tissue and of visceral fat. We also studied the biochemical and immunochemical parameters of their metabolism: the levels of fasting blood glucose, postprandial glucose, glycated hemoglobin (HbA1c), immunoreactive insulin, and C-peptide, together with their lipid profiles.

Results. The metabolic changes identified are typical of patients with BA and COPD. Obesity was observed in 45.5% of patients with COPD and 62% of patients with BA. Calculation of the WC/height index, and assessing data obtained using bioelectrical impedance analysis can help optimise the diagnosis of obesity. As patients with BA and COPD are fairly likely to develop dyslipidemia this reveals the need for thorough studies of their lipid profiles that can help in the calculation the levels of apolipoproteins A1 and B. In both groups a high frequency of diabetes mellitus was registered, reaching 33% in the group of patients with BA. The identification and diagnosis of diabetes mellitus or of early disorders of carbohydrate metabolism amongst hospitalised patients with BA and COPD is impossible without testing fasting blood glucose and the dynamics of postprandial glucose in addition to determining the level of HbA1c.

Conclusion. Regular screening for metabolic disorders among patients with BA and COPD will enable optimisation of their treatment and could reduce the severity of the diseases, as well as decreasing the risk of cardiovascular, endocrinal or pulmonary mortality.


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