COMPARATIVE ASSESSMENT OF THE TREATMENT EFFECTIVENESS OF ASTHMA PATIENTS WITH OBESITY DEPENDING ON THE AGE OF DEBUT
DOI:
https://doi.org/10.11603/1811-2471.2024.v.i1.14531Keywords:
asthma, obesity, debut, transforming growth factor-β, control, lung function, atorvastatin, vitamin DAbstract
SUMMARY. The aim – comparative evaluation of the clinical and laboratory effectiveness of atorvastatin and vitamin D in addition to basic treatment of asthma patients with obesity depending on the age of onset.
Material and Methods. 195 asthma patients with obesity and 95 practically healthy individuals were examined. Patients were divided into two groups depending on the age of asthma onset: the 1st group included 100 patients with an early onset, and the 2nd group – 95 with a late onset. Patients with complete control at baseline visit and those who achieved control after adjustment of baseline treatment were excluded from further study. Patients of I (n=65) and II groups (n=68) were divided into subgroups A, B and C: IA (n=23) and IIA (n=22) subgroups received basic treatment in combination with vitamin D; IB (n=20) and IIB (n=25) – with atorvastatin; IC (n=22) and IIC (n=21) – only basic therapy. TGF-β1 level was determined using IBL International GMBH (Hamburg, Germany) enzyme immunoassay kits. The content of 25(OH)D was determined by an immunochemical method with chemiluminescence detection (Abbott Diagnostics, USA). Asthma control was assessed using the ACQ-5 questionnaire. The study was approved by the Bioethics Commission of the Educational and Scientific Medical Institute of Sumy State University. Statistical analysis of the obtained results was carried out using the SPSS-17 program.
Results. The level of TGF-β1 in patients with early asthma with obesity did not change against the background of basic treatment, however was lower, in groups with a combination of atorvastatin and vitamin D (p=0.001) and was lower compared to that in patients with IB and IC subgroups. In patients with late-onset asthma, the level of TGF-β1 was lower in IIA (p=0.001) and IIB (p=0.001) subgroups. A decreasing in TGF-β1 was accompanied by an increase in the level of vitamin D only in patients with IA (p=0.001) and IIA (p=0.001) subgroups. A medium-strength negative correlation was found in patients of the I (r= - 0.523; p=0.001) and II (r=- 0.379; p=0.001) groups between the level of vitamin D and TGF-β1. There was an increase in the level of asthma control in patients of IA and IB subgroups, but it was higher in IA compared to patients of B (p=0.001) and C (p=0.001) subgroups. Control of late asthma increased in patients of all subgroups, but its level was higher in patients with IIB compared to IIA (p=0.001) and IIC (p=0.017) subgroups. Lung Function significantly increased in patients with early asthma in the group who received basic treatment with vitamin D, and in patients with late asthma with the add-on of atorvastatin.
Conclusions. The content of TGF-β1 significantly decreased in patients of IA, IIa and IIB subgroups. Vitamin D content increased in patients of IA and IIA subgroups. A medium strength correlation was revealed in patients of I (r=-0.523; p=0.001) and II (r=-0.379; p=0.001) groups between the content of vitamin D and TGF-β1. Higher control and better improvement of lung function were in patients with early asthma and obesity who had the combination of basic therapy with vitamin D, and in patients with late asthma with the add-on of atorvastatin.
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