كلية الطب والعلوم الصحية
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Item Indicators of metabolic syndrome among patients with bronchial asthma(Al-Neelain University, 2021) Hanadi Abdelgadir Ahmed SourgABSTRACT Background: Much evidence suggests epidemiological and etiological links between the metabolic syndrome (MS) and bronchial asthma (BA). Hyperglycemia, hyperinsulinemia, insulin resistance (IR), hypertension, dyslipidemia, and obesity were all described in the pathophysiological mechanisms of BA. Objectives: To compare anthropometric measurements and other indicators of body fat distribution, blood pressure (BP), fasting blood glucose (FBG) level, fasting blood insulin (FBI) level, quantitative insulin sensitivity check index (QUICKI), and a serum lipid profile between asthmatic patients and healthy control subjects. Method: One hundred twenty asthmatic patients were recruited from chest referral clinic (Military Hospital, Khartoum, Sudan) and served as the test group. Another 59 non-asthmatic subjects were recruited by co-patients, or by university students/employees, and served as the control group. Following clinical and spirometric evaluation of the subjects, the following items were measured: body weight, height, waist circumference (WC), hip circumference (HC), triceps skinfold (TSF), biceps skinfold (BSF), subscapular skinfold (SSSF) and suprailiac skinfold (SISF) thicknesses – as well as the ratio between waist and hip circumference (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial blood pressure (MABP), FBG and FBI levels, the QUICKI, and a serum lipid profile. Body fat percent (BF %) and body mass index (BMI) were also calculated. Based on BMI, studied subjects were categorized in four classes: underweight, normal weight, overweight, and obese. Cigarette smoking, pregnancy, those below 20 years or above 40 years, diabetes mellitus and hypertension, and other chronic diseases were excluded from all studied groups. Results: Although BMI, HC, TSF, BSF, SSSF, SISF, and BF% were higher in asthmatic patients compared to non-asthmatic subjects, the difference for each of these parameters did not reach statistical significance. WC and WHR were significantly higher in asthmatic patients (88.50 (78.00-101.75), 83.00 (78.47- 90.17)) compared to non-asthmatic subjects (81.00 (72.00- 92.00), 80.00 (75.67- 85.10), P = 0.004, 0.003). BA symptoms in underweight subjects was comparable to normal BMI subjects (OR=1.05). However, BA prevalence increases steadily in overweight (OR=1.46) and obese subjects (OR=2.67), compared to normal BMI subjects. The presence of symptoms during the study increased in underweight (OR=3.55), overweight (OR=2.13), as well as obese (OR=3.43), versus normal BMI subjects. QUICKI and MABP were lower in asthmatic patients (0.310 (0.283- 0.338), 86.66 (83.33- 93.33)) compared to non-asthmatic subjects [0.320 (0.297-0.353), 93.33 (83.33- 93.33)], P < 0.05). BMI, FBG, low density lipoprotein (LDL), high density lipoprotein (HDL), and total cholesterol were comparable in the studied group except triglyceride (TG) which was high in asthmatic patients. Conclusions: Study results provide further evidence of the association between BA and central obesity. All indicators of body fat distribution were higher in asthmatic patients compared to non-asthmatic subjects, although only WC and WHR reached statistical significance: this points to the relevance of abdominal obesity in the pathophysiology of BA. The present findings also suggest that hypertriglyceridemia, hyperinsulinemia, and IR may be interacting, thereby increasing the risk of BA in normotensive, normoglycemic asthmatic subjects. ARABIC ABSTRCT المستخلص الخلفية: تشير العديد من الأدلة الوبائية والسببية الي وجود رابط بين متلازمة الأيض والربو الشعبي. وصف ارتفاع السكر والأنسولين و ضغط الدم واضطراب شحوم الدم والسمنة بارتباطهم بالفيزيولوجيا المرضية للربو الشعبي. الاهداف: مقارنة القياسات البشرية ونسبة توزيع الدهون في الجسم وضغط الدم وسكر الدم الصائم وهرمون الانسولين ومؤشر فحص حساسية الانسولين الكمي ومعالم الدهون بين مرضي الربو الشعبي والاصحاء. الطريقة: أجريت هذه الدراسة في 120 من مرضى الربو الشعبي الذين يترددون على العيادة المحولة في المستشفى العسكري بالخرطوم و59 صحيح من مرافقين للمرضي والعاملين وطلاب الجامعات من نفس الفئة العمرية (20-40 سنه) من الجنسين. بعد اجراء الفحص السريري وقياس وظائف الرئة للخاضعين للدراسة تم قياس العناصر التالية: وزن الجسم، والطول، محيط الخصر والحوض، وسمك طيات الجلد من اربعة نقاط، ضغط الدم، تركيز السكر والانسولين ومعالم الدهون في الدم بعد الصيام، مؤشر فحص الحساسية الانسولين الكمي، نسبة الدهون في الجسم ومؤشر كتلة الجسم. وتم تقسيم المرضي علي اساس مؤشر كتلة الجسم وتم استبعاد كل من المدخنين، والحوامل، مرضي السكري وضغط الدم والامراض المزمنة. النتائج: وجد أن محيط الخصر ونسبة محيط الخصر للحوض في مرضي الربو الشعبي (88.50 (78.00-101.75)، 83.00 (78.47- 90.17)) ذو اهمية احصائية عالية مقارنة بالأصحاء (81.00 (72.00- 92.00)، 80.00 (75.67- 85.10)، (P= 0.004, 0.003). غير أن ارتفاع مؤشر كتلة الجسم، ومحيط الخصر وسمك ثنية الجلد من اربعة نقاط الذي سجل في مرضي الربو الشعبي مقارنة بالأصحاء ليست بذات اهمية احصائية.