Obesity And Bronchial Asthma Phenotypes

Objective:By comparing The symptom score, acute attack number before see a doctor fractional exhaled nitric oxide,pulmonary function,total IgE and improve the relevant indicators after standard treatment between obesity and non-obese patients with asthma, to assessment of disease differences between obese patients with asthma and non-obese patients with asthma,and to explore the correlation between the mass index and fractional exhaled nitric oxide.Methods:Choose patients with respiratoty symptoms including wheezing, chest tightness, cough, dyspnea enrolled from June to December in2011,in Tianjin First Central Hospital respiratory clinic. The Global Initiative for Asthma (GINA) of2009was defined the standard for bronchial asthma diagnosis and except for the Upper respiratory tract infection, Acute bronchitis, Pulmonary heart disease, Cardiac asthma and other respiratory and other system diseases.78cases patient were diagnosed firstly as bronchial asthma(moderate duration)and never get any therapy.By measuring the height, weight and get body mass index (BMI),then the asthma group were divided into group Ⅰ (BMI≥28kg/m2, obesity asthma,18cases) and Group Ⅱ (BMI<28kg/m2, non-obese asthma,60cases). After8weeks of regular inhaled the same dose of Seretide therapy, Group Ⅰ and Group Ⅱ are known as la group and Ⅱa group.Comparing the symptom score, acute attack number before see a doctor,lung function, exhaled nitric oxide (FeNO), total IgE of two groups patients, as well as the related indicators improved situation of two groups patients after treatment by statistical methods,and analysis differences between Group1and Group2;Study the relationship of asthma group between BMI and FeNO by statistical method.Results:1,Age, gender, number of smoke people,family history and history of allergieswas no significant differences between Ⅰ groups and Ⅱ groups (P>0.05);2, Group I AQLQ symptom score is low, Acute attack patientmore before see a doctor is more (P<0.05).3,FEV,/FVC ratio (%),FEV1%pred,PEF%pred and PEF variation rate (%) was no significant difference between Group Ⅰ and Group Ⅱ (P>0.05); R5, R20, R5-R20of Group Ⅰ was greater than Group Ⅱ, while FRC%pred and MMEF%pred of Group I less than Group Ⅱ (P<0.05).4, FeNO of group I was lower than group Ⅱ (P <0.05).5. FeNO,FEV1%pred and PEF%pred was no significant difference between group Ⅰ and group la (P>0.05); Compared to Group II,FeNO and the PEF%pred of Group Ⅱa was reduced (P<0.05) while FEV1%pred no significant difference (P>0.05); Group la ACT score lower than Group Ⅱ(P<0.05), indicating sensitivity of glucocorticoid treatment in Group I patients with asthma was lower than Group II.6.There was negatively correlated between BMI and FeNO in group I patients (r=-0.608, P<0.05).Conclusion:1, Subjective symptoms of the obese patients with asthma are more serious, more prone to acute asthma attacks.2, Obesity asthma have more severe illness and worse lung function.3, FeNO in obesity asthma patients was reduceder than non-obese asthma patients.4, Comparing with the non-obese asthma, obesity asthma more difficult to control and glucocorticoid less effective.5, BMI and FeNO was negatively correlated in untreated obesity asthma patients.