Abstract
The potential mechanisms of bronchial asthma (BA) negative modification under the influence of obesity are currently being actively studied. However, at present, the effect of nutritional status on bronchial obstruction in children with BA cannot be considered established. In this regard, the purpose of this work was to study the relationship of spirometric parameters reflecting bronchial patency with nutritional status in children with asthma.Materials and Methods.The study involved 54 patients with BA at the age of 8 to 17 years, 33 boys and 21 girls with different nutritional status. Assessment of nutritional status was carried out with the calculation of body mass index (BMI), relative body mass index (RBMI), and determination of body fat (% BF). Spirogram parameters were evaluated, including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC ratio, maximum expiratory flow at the point of 25% loop flow-volume (MEF 25).Results.Among the children examined, taking into account the BMI Z-score, 9.3% (5/54) had low body weight (group 1), 33% (18/54) had normal body weight (group 2), 31.5% (17/54) overweight (group 3), 25.9% (14/54) obesity (group 4). As the body weight increased, a statistically significant decrease in the FEV1/FVC ratio was observed, amounting to 84.6 [79.3; 90.0], 79.4 [76.6; 82.2], 74.6 [71.7; 77.5], 70.2 [67.0; 73.4]%, respectively, p=0.003; as well as a decrease in MEF 25 (% pred.), which amounted, respectively, to 95.6 [76.1; 115.2], 81.7 [71.4; 92.0], 56.3 [45.7; 66.9], and 48.4 [36.7; 60.1]%, p=0.003. A statistically significant negative relationship was found between indicators of nutritional status, including BMI, RBMI, % BF, and spirometry parameters reflecting bronchial patency, including FEV1/FVC ratio and MEF 25 (% pred.); all p<0.01.Conclusions.Overweight and obesity in children with BA, estimated both by calculated methods with determination of BMI and RBMI and direct determination of body fat content, are accompanied by a statistically significant decrease in bronchial patency.
Highlights
Bronchial asthma (BA) is a heterogeneous disease characterized by the presence of respiratory symptoms such as wheezing, shortness of breath, chest congestion, and cough that vary in time and intensity and are associated with reversible bronchial patency disorder [1]
We proposed a method for studying nutritional status in children with the introduction of the RBMI parameter, which is calculated as the ratio of patient body mass index (BMI) and median BMI values for a given age and sex, reflected in the WHO materials [11, 24]
The present study aims to work the relationship of spirometric parameters reflecting bronchial patency with BMI, RBMI, and body fat in children with asthma
Summary
Bronchial asthma (BA) is a heterogeneous disease characterized by the presence of respiratory symptoms such as wheezing, shortness of breath, chest congestion, and cough that vary in time and intensity and are associated with reversible bronchial patency disorder [1]. It is believed that control of BA can be achieved in all patients, this is emphasized in the international conciliation documents, including GINA 2019 [1]. According to Braido et al [3], up to 56% of patients do not have a proper level of disease control. One of the significant obstacles to achieving BA control is the presence of comorbid conditions [4,5,6,7,8]
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