Kazan medical journalKazan medical journal0368-48142587-9359Eco-Vector840310.17816/KMJ2018-181Research ArticlePrediction of adult-onset bronchial asthma in patients with metabolic syndrom in actual practiceKosmyninaM Akosmynina_mary@mail.ruKupaevV Ikosmynina_mary@mail.ruIDK Medical Company JSCSamara State University1504201899218118730032018Copyright © 2018, Kosmynina M.A., Kupaev V.I.2018<p><strong>Aim.</strong> Adult asthma diagnosis optimization for patients with metabolic syndrome using prognostic methods.</p>
<p><strong>Methods.</strong> The study included 46 patients with metabolic syndrome. Out of them, at the time of the study 31 subjects suffered from adult-onset bronchial asthma. All participants of the study had a history and complaints collected, and a clinical examination performed. Spirometry was used to assess the severity of bronchial obstruction syndrome. To assess the severity of metabolic syndrome components, glucose and fasting insulin concentrations, and lipid profile were determined, the homeostasis index of insulin resistance was calculated. Also in all participants the concentrations of leptin and endothelin-1 in the serum were determined.</p>
<p><strong>Results.</strong> Risk of adult-onset bronchial asthma in a typical patient with metabolic syndrome spikes with maximal blood pressure higher than 154/90 mm Hg, and immunoglobulin E and leptin level higher than 33 ME/ml and 3.7 ng/ml, respectively. Blood pressure level affects adult-onset bronchial asthma pathogenesis only in combination with other metabolic syndrome components. Immunoglobulin E-mediated reactions play an important role in the pathogenesis of adult-onset bronchial asthma, and leptin acts as a regulator of pathogenetic mechanism.</p>
<p><strong>Conclusion.</strong> Development of adult-onset bronchial asthma in patients with metabolic syndrome may be predicted on the basis of various variables; according to our data, those variables include maximum systolic and diastolic blood pressure levels, and levels of immunoglobulin E and leptin.</p>adult-onset bronchial asthmametabolic syndromelogistic regressionarterial hypertensionimmunoglobulin Eleptinпоздно возникшая бронхиальная астмаметаболический синдромлогистическая регрессияартериальная гипертензияиммуноглобулин Елептин[Dixon A.E., Clerisme-Beaty E.M. (Eds.) Obesity and lung disease. A guide to management. Humana Press. 2013; 250 p. DOI: 10.1007/978-1-62703-053-3.][Assad N., Qualls C., Smith L.J. et al. Body mass index is a stronger predictor than the metabolic syndrome for future asthma in women. The longitudinal CARDIA study. Am. J. Respir. Crit. Care Med. 2013; 188 (3): 319–326. DOI: 10.1164/rccm.201303-0457OC.][Thuesen B.H., Husemoen L.L.N., Hersoug L.G. et al. Insulin resistance as a predictor of incident asthma-like symptoms in adults. Clin. Exp. Allergy. 2009; 39: 700–707. DOI: 10.1111/j.1365-2222.2008.03197.x.][Lee E.J., In K.H., Ha E.S. et al. Asthma-like symptoms are increased in the metabolic syndrome. J. Asthma. 2009; 46: 339–342. DOI: 10.1080/02770900802660931.][Choi J.H., Park S., Shin Y.H. et al. Sex differences in the relationship between metabolic syndrome and pulmonary function: the 2007 Korean National Health and Nutrition Examination Survey. Endocr. J. 2011; 58: 459–465. DOI: 10.1507/endocrj.K11E-011.][Platts-Mills T.A.E. The role of IgE in allergy and asthma. Am. J. Respir. Crit. Care Med. 2001; 164: 1–5. DOI: 10.1164/ajrccm.164.supplement_1.2103024.][Sood A., Ford E.S., Camargo Jr.C.A. Association between leptin and asthma in adults. Thorax. 2006; 61: 300–305. DOI: 10.1136/thx.2004.031468.][Kosmynina M.A. Clinical and pathogenetic relationship betweeb adult-onset asthma and metabolic syndrome components. Izvestiya Samarskogo nauchnogo tsentra RAN. 2015; 17 (5-3): 798–802. (In Russ.)][Chen W.-L., Wang C.-C., Wu L.-W. et al. Relationship between lung function and metabolic syndrome. PLoS ONE. 2014; 9 (10): e108989. DOI: 10.1371/journal.pone.0108989.][Alwan A.H., Alobaidi A.H.A., Alsamarai A.M. Leptin, obesity and IgE in patients with asthma and allergic rhinitis. Diyala J. Med. 2014; 6 (1): 66–76.][Guler N., Kirerleri E., Ones U. et al. Leptin: does it have any role in childhood asthma? J. Allergy Clin. Immunol. 2004; 114: 254–259. DOI: 10.1016/j.jaci.2004.03.053.][Lugogo N.L., Hollingsworth J.W., Howell D.L. et al. Alveolar macrophages from overweight/obese subjects with asthma demonstrate a proinflammatory phenotype. Am. J. Respir. Crit. Care Med. 2012; 186 (5): 404–411. DOI: 10.1164/rccm.201109-1671OC.][Shore S.A., Schwartzman I.N., Mellema M.S. et al. Effect of leptin on allergic airway responses in mice. J. Allergy Clin. Immunol. 2005; 115: 103–109. DOI: 10.1016/j.jaci.2004.10.007.][Leivo-Korpela S., Lehtimäki L., Vuolteenaho K. et al. Adipokine resistin predicts anti-inflammatory effect of glucocorticoids in asthma. J. Inflamm. (Lond.). 2011; 8: 12. DOI: 10.1186/1476-9255-8-12.][Bruno A., Pace E., Chanez P. et al. Leptin and leptin receptor expression in asthma. J. Allergy Clin. Immunol. 2009; 124 (2): 230–237. DOI: 10.1016/j.jaci.2009.04.032.]