Asma metabólica: evidências atuais e perspectivas terapêuticas

Abstract

Asthma and obesity are associated from both the epidemiological and pathophysiological point of view. Longitudinal studies indicate that, in general, obesity precedes asthma, and that relative risk for asthma increases with obesity. Furthermore, weight reduction in obese asthmatics results in decreased severity of the disease. The so-called "obese phenotype" of childhood asthma has distinct characteristics of lung function, bronchial hyperresponsiveness, non-eosinophilic airway inflammation and worse control of symptoms with inhaled corticosteroids. More recently, it has also been observed the association between asthma and metabolic syndrome (MS) and its components such as insulin resistance, hyperglycemia and hypertension, regardless of body mass index. Oxidative dysfunction of the bronchial epithelium and systemic inflammation associated with MS appear to contribute to the pathogenesis of asthma. This review article discusses the current scientific evidence about the pathophysiological mechanisms of the association between asthma and components of the metabolic syndrome, as well as future prospects in the management of patients with these chronic diseases of high prevalence and morbidity in childhood and adolescence.