Clinical and functional characteristics of patients with bronchial asthma depending on body mass index

Abstract

The aim of the study was to investigate the relationship between body mass index (BMI) and clinical and anamnestic data in patients with bronchial asthma (BA). Material and methods. 553 patients with BA and 95 apparently healthy individuals without medical or family history of asthma, allergy or atopy symptoms were examined. Patients were divided into three groups depending on BMI: Group I included 152 patients with normal body weight (NBW), II – 206 overweight patients, III – 195 with obesity. BA control was assessed by using the ACQ-5 questionnaire, and the AQLQ was used to assess quality of life. The study was approved by the Bioethics Commission of the Medical Institute of Sumy State University. Statistical analysis of the obtained results was carried out using the SPSS-17 program. Results. There were no significant sex– and age-related differences (p > 0.05) between clinical groups. Complaints, medical history, clinical and instrumental indicators, disease severity, control, and quality of life of patients were analyzed to identify features of BA associated with obesity. The study has found that BA patients with obesity experienced a higher frequency of positive family history (p = 0.004), exacerbations during the cold season (p = 0.001), sensitivity to weather changes (p = 0.001), acute respiratory diseases (p = 0.001), stress (p = 0.001), and a combination of non-specific triggers (p = 0.001) which could result in exacerbations compared to patients with NBW. Exacerbations caused by flowering plants were more common in BA patients with NBW (55.3 %) compared to those with obesity (43.1 %). When comparing BA in individuals with obesity to those with NBW, there were several distinctive features. These included a higher frequency of symptoms such as cough and shortness of breath at rest or with minor physical exertion, weakness, fatigue, sleep disturbances, heartburn; night and day symptoms when using salbutamol, a severe and uncontrolled course with more pronounced obstructive disorders and lower reversibility, pneumonia, exacerbation episodes, and lower quality of life. Conclusions. BA with obesity compared to BA with NBW is characterized by a number of differences such as non-allergic factors as triggers, more severe course, lower level of control and quality of life, pain, pronounced bronchial obstruction with lower reversibility.