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哮喘与诊断为代谢综合征患者的关联:一项三级护理医院的队列研究。

Association of Asthma With Patients Diagnosed With Metabolic Syndrome: A Cohort Study in a Tertiary Care Hospital.

作者信息

G Jishna, Abraham Elen, Verma Ghanshyam, Mathew Leny T, Acharya Sourya, Kumar Sunil, Saboo Keyur, Gemnani Rinkle

机构信息

Department of Respiratory Medicine, Sree Balaji Medical College and Hospital, Chennai, IND.

Department of Neurology, Mar Baselios Medical Mission Hospital, Ernakulam, IND.

出版信息

Cureus. 2023 Oct 24;15(10):e47558. doi: 10.7759/cureus.47558. eCollection 2023 Oct.

Abstract

Introduction Asthma is defined as a chronic inflammatory airway disease. The prevalence of both asthma and obesity has been rising simultaneously, demonstrating a parallel trend. Obesity is a significant factor in metabolic syndrome, and numerous studies have indicated a connection between metabolic syndrome and bronchial asthma. Aims and objectives The aim of this paper is to evaluate the association of asthma with patients diagnosed with metabolic syndrome. The main objectives were to analyze the clinical profile and spirometric indices in patients with metabolic syndrome and to assess asthmatic patients among them with spirometry and clinical parameters at a tertiary care hospital in Chennai. Materials and methods This hospital-based cohort study was conducted on 73 patients attending the outpatient department who had a known case of metabolic syndrome and were evaluated for asthma through history, physical examination, and a pulmonary function test. A history of cough, expectoration, shortness of breath, wheezing, chest tightness, allergy, seasonal variation, and smoking habits was asked, and a thorough physical examination was performed. Bronchial asthma was confirmed with airflow reversibility by spirometry as per the Global Initiative for Asthma Guidelines. Metabolic and spirometry parameters were examined, such as body mass index (BMI), waist circumference, waist-hip ratio, fasting blood sugar (FBS), postprandial blood sugar, hemoglobin A1C (HbA1C), serum insulin, lipid profile, C-reactive protein (CRP), forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), and FEV1/FVC pre- and post-reversibility (baseline vs. six months). Results and discussion The average BMI of all participants was 29.6511 ±2.64564. The waist-hip ratio was 0.5512 ±0.43855, which decreased during the follow-ups, demonstrating a decline in the risk of obesity in study participants. The level of HbA1C showed a drop from 6.1% to 5.9% at the first follow-up. This exhibited a further reduction at the six-month follow-up in addition to a positive reflection in insulin sensitivity, indicating successful control of diabetes among study participants. It was discovered that this was statistically significant (p<0.001). At the third and sixth months of follow-up, the FEV1/FVC ratio increased by 38% and 37%, respectively, when metabolic syndrome was under control. The results show that controlling diabetes, hypertension, obesity, and triglyceride values improved asthmatic symptoms, and this was determined to be statistically significant (p<0.001). Conclusion The results of the current study demonstrated that the regulation and maintenance of metabolic parameters such as BMI, diabetes, hyperlipidemia, and hypertension aid in improving asthma control.

摘要

引言

哮喘被定义为一种慢性炎症性气道疾病。哮喘和肥胖的患病率一直在同时上升,呈现出平行趋势。肥胖是代谢综合征的一个重要因素,众多研究表明代谢综合征与支气管哮喘之间存在联系。

目的

本文旨在评估哮喘与被诊断为代谢综合征的患者之间的关联。主要目标是分析代谢综合征患者的临床特征和肺功能指标,并在金奈的一家三级护理医院通过肺功能测定和临床参数评估其中的哮喘患者。

材料与方法

这项基于医院的队列研究对73名门诊患者进行,这些患者患有已知的代谢综合征病例,并通过病史、体格检查和肺功能测试对哮喘进行评估。询问了咳嗽、咳痰、气短、喘息、胸闷、过敏、季节性变化和吸烟习惯等病史,并进行了全面的体格检查。根据全球哮喘防治创议指南,通过肺功能测定的气流可逆性确诊支气管哮喘。检查了代谢和肺功能参数,如体重指数(BMI)、腰围、腰臀比、空腹血糖(FBS)、餐后血糖、糖化血红蛋白(HbA1C)、血清胰岛素、血脂谱、C反应蛋白(CRP)、第一秒用力呼气量(FEV1)、用力肺活量(FVC)以及可逆性前后(基线与六个月)的FEV1/FVC。

结果与讨论

所有参与者的平均BMI为29.651±2.64564。腰臀比为0.5512±0.43855,在随访期间有所下降,表明研究参与者肥胖风险降低。HbA1C水平在首次随访时从6.1%降至5.9%。在六个月的随访中进一步下降,同时胰岛素敏感性呈阳性反应,表明研究参与者的糖尿病得到成功控制。发现这具有统计学意义(p<0.001)。在随访的第三个月和第六个月,当代谢综合征得到控制时,FEV1/FVC比值分别增加了38%和37%。结果表明,控制糖尿病、高血压、肥胖和甘油三酯值可改善哮喘症状,这被确定具有统计学意义(p<0.001)。

结论

当前研究结果表明,对BMI、糖尿病、高脂血症和高血压等代谢参数的调节和维持有助于改善哮喘控制。

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