ВЛИЯНИЕ НИЗКОЙ МАССЫ ТЕЛА НА ПАРАМЕТРЫ ВНЕШНЕГО ДЫХАНИЯ И УРОВЕНЬ ЭОЗИНОФИЛОВ ПЕРИФЕРИЧЕСКОЙ КРОВИ У ДЕТЕЙ И ПОДРОСТКОВ С БРОНХИАЛЬНОЙ АСТМОЙ

Abstract

Current data on the relationship between the body mass index (BMI) and low body weight (BW) and the lung function and peripheral blood eosinophils count in children and adolescents with bronchial asthma (BA) are contradictory. The purpose of this research was to study the relationship between BMI, spirometry parameters and the level of peripheral blood eosinophils in children and adolescents with BA. Materials and methods used: a single-center observational cross-sectional pilot study of 240 children and adolescents with BA of median age 12.0 [9.0; 15.0] y/o, of which 165 (68.8%) were boys, who were divided into two groups based on anthropometric measurements performed to calculate BMI and zBMI: G1 of those with normal BW (BMI -1Z to +1Z) and G2 with LBW (BMI below -1Z). The following spirometry parameters were analyzed: forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and FEV1/FVC ratio (absolute values and Z-scores). Results: absolute values of FVC and FEV1 in LBW patients were slightly lower than in patients with normal BW, the differences were trendy (p=0.055 and p=0.108, respectively). At the same time, zFVC and zFEV1 in low BW patients were statistically significantly lower than in patients with normal BW, amounting to 0.440±1.210 and 1.06±1.130 (p<0.001) for zFVC, respectively, and for zFEV1 -0.241 [-0.974; 0.576] and 0.304 [-0.397; 1.00] (p=0.002). The values of both FEV1/FVC and zFEV1/FVC between these BMI groups did not have statistically significant differences (p=0.462 and p=0.300). Analysis of the relationships between zBMI and z-values of spirometric parameters revealed a significant direct relationship between zBMI and zFVC (R=0.308, p<0.001), as well as a direct, significant, but less pronounced relationship between zBMI and zFEV1 (R=0.20, p=0.002). The relationship between zBMI and zFEV1/FVC was negative (R=-0.11) and did not have statistical significance (p=0.097). The absolute content of eosinophils in peripheral blood was significantly higher in patients with low BW (p=0.006) and had a significant negative relationship with zBMI (R=-0.217, p=0.023). Conclusion: zFVC and zFEV1 values are lower in children and adolescents with BA and low BW and the absolute count of eosinophils in peripheral blood is higher than in patients with normal BW. Therefore, maintaining nutritional status may be an important component of the formation of the respiratory system and an adequate immune response in children and adolescents with BA.