Thickness of epicardial fat tissue as a marker of various obesity phenotypes in young patients with bronchial asthma

Abstract

One of the directions in the study of diseases is their phenotyping. Thus, understanding the peculiarities of bronchial asthma (BA) and various types of obesity phenotypes combination will not only provide a differentiated approach to treatment, but also achieve maximum therapeutic effect. The aim of this study was to evaluate clinical and laboratory features of various obesity phenotypes in BA patients at a young age in order to optimize antiasthmatic therapy and early diagnosis of cardiovascular complications. Methods. Patients with BA of different severity were examined (n = 164); the control group was made up of relatively healthy subjects (n = 40). The subjects were divided into groups with BMI (Body Mass Index); the 1st group (n = 93) included patients with BMI 18.5-24.9 kg/m2; the 2nd group (n = 80) included BA patients with BMI 30-34.9 kg/m2 (1st degree obesity). Overweight patients were detected, clinical and functional examination was performed, epicardial adipose tissue thickness (EATT) was measured by standard two-dimensional echocardiography (EchoCG), obesity degree, cytokine, adipokine, insulin levels, insulin resistance indices were determined. Results. According to the results of the study in patients with BA and metabolic fat obesity phenotype (MFOP) a significant disorder of adipokine balance was revealed, carbohydrate metabolism disorder was noted, and significantly higher insulin levels were observed, insulin resistance index (Homeostasis Model Assessment of Insulin Resistance - HOMA-IR) and decrease in insulin sensitivity index (ISI) relative to the group of patients with metabolically healthy obesity phenotype and control. Conclusion. It has been established that the EATT determined by the EchoCG method can serve as a predictor of MFOP and a risk factor for cardiovascular diseases.