O. Slaba

Danylo Halytsky Lviv National Medical University

Introduction. Despite the progress in the diagnosis and treatment of bronchial asthma (BA), the tendency to increase the incidence is observed in all age groups. Particular attention is drawn to the increase in the incidence of asthma in economically developed countries, where the problem of obesity has become extremely urgent.

Aim. Determine the level of adiponectin in the blood of asthma patients and determine the clinical and laboratory and instrumental parameters depending on it.

Material and methods. On the basis of the allergological department of the 1-st Clinical Hospital in Lviv, a comprehensive clinical and laboratory examination of 20 patients with asthma (12 men aged 18 to 59 years old and 8 women aged from 24 to 80 years) was conducted. The criterion for inclusion in the study was the presence of clinical symptoms of asthma, instrumental confirmation of broncho-obstructive syndrome daily oscillation and a test with bronchodilator. For all the patients the general examination (complaints, anamnesis, and complete physical examination) and anthropometric examinations: body mass, body height and body mass index (BMI) were conducted. In addition to standard laboratory studies, based on the indicators of complete blood count, leukocyte index of intoxication was determined, the growth of which indicates endogenous intoxication and tissue decay processes. High-speed and volumetric indicators of external respiration were determined using a computer spirograph “Pneumoscreen”.

Results and discussion. The median adiponectin in the examined patients with asthma was 114.6 [90.0; 139.1] ng/l. Significantly different values of adiponectin were seen in patients with varying degrees of severity of the disease. Thus, in patients with severe asthma, the lowest level of adiponectin was 83.5 ng/l, which is significantly lower than in the case of light persistent flow (132.3 [111.8; 171.8] ng/l; p = 0.03). Obesity in patients with asthma was accompanied by the lowest levels of adiponectin in the blood. Analysis of the correlation of adiponectin in subgroups of patients with its level below and above the median showed that in patients with lower levels, the adiponectin content correlated with the largest number of clinical, laboratory and instrumental parameters. The process of reducing adiponectin is associated with longer illness and male gender. According to the correlation analysis, in the conditions of the initial higher level of adiponectin it is unfavorable for the course of asthma as a decrease in its content, which is associated with an increase in severity (τ = -0,5; p = 0,049) and the deepening of endogenous intoxication (τ = -0,5; p = 0.049), and subsequent increase in the amount of adiponectin accompanied by systolic and diastolic arterial hypertension (τ = 0.6; p = 0.02 and τ = 0.6; p = 0.03) and tachycardia (τ = 0 , 5; p = 0.04).

Conclusions. It was found that the lowest levels of adiponectin in patients with asthma are observed during the severe course of the disease and in case of obesity. Hypoadiponectinemia is often accompanied by a complicated course of asthma and a decrease in both volumetric, and high-speed function respiratory tests.

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