Study Of Serum Adiponectin Level In Obese And Non-obese Asthmatic Patients:

Ismaeil Mohammad Farag

Asthma is associated with airway inflammation and reversible airflowobstruction.Obesity has recently been identified as a major risk factor for thedevelopment of asthma. Obese asthma patients have more severe disease withincreased asthma exacerbations, decreased asthma control, and decreased steroidresponsiveness and is becoming a major public health issue in many countries.Adiponectin is a protein specifically secreted from adipose tissue. It circulatesto influence other organs as the liver, skeletal muscles, and blood vessels. Anauto/paracrine effect on adipose tissue also exists. It has antidiabetic (by promotinginsulin sensitivity), anti-inflammatory and anti-atherogenic effects. Its secretion isinfluenced by different hormones and cytokines. Hypoadiponectinemia is observedin obesity, type 2 diabetes, hypertension, coronary artery disease and bronchialasthma.This work aimed to determine whether serum concentration of adiponectinchange in asthmatic patients during acute attack and in remission and whether thesechanges correlate with the changes in ventillatory functions.This study included 55 cases.40 patients with bronchial asthma (20 obese and20 nonobese) and 15 age related healthy subject as a control (7 obese and 8nonobese).The range of body mass index (k/m2) in obese control subjects was from 31.7to 35.8(k/m2) with the mean body mass index 34 ± 1.4(k/m2).while in nonobesecontrol subjects from 22.6 to 24.9 (k/m2) with the mean body mass index 23.7±1(k/m2). In obese asthmatics the range was from 30.1to 35.8 (k/m2) with theSummary

mean body mass index 32.8±1.6(k/m2) .while in nonobese asthmatics the rangewas from 19.1 to 24.9 (k/m2) with the mean body mass index 22 ± 1.7(k/m2).The range of age in in obese control subjects was from 29 to 39 years with themean age 34.5 ± 4.4 years while in nonobese control subjects from 33 to 50 yearswith the mean age 42.4 ± 7.35 years.In obese asthmatics the range was from 29 to52 years with the mean age 39.5 ± 6.95 years while in nonobese asthmatics therange was from 25 to 51 years with the mean age 35.5 ± 7.2 years.The results also showed the sex distribution among the studied groups.25males included in this study,3 obese control subjects ,4 nonobese control subjects,8 obese asthmatics and10 nonobese asthmatics.30 females included in this study, 4obese control subjects ,4 nonobese control subjects,12 obese asthmatics and 10nonobese asthmatics.In this study, statistical comparison of ventillatory function tests were doneamong all studied groups,The mean value of FVC, FEV1(%pred), FEV1/FVC,FEF25-75(%pred) in obese control subjects was 86,81,94.1,90 respectively whilein nonobese control subjects was 90,85,94.4,94 respectively.In obese asthmaticsthe mean value of FVC, FEV1(%pred), FEV1/FVC, FEF25-75(%pred) duringattack was 65,27,41.5,35 respectively and during remission was83.3,75,90,74,while in nonobese asthmatics the mean value of FVC,FEV1(%pred),FEV1/FVC, FEF25-75 (%pred) during attack was 65.2,30,46,41.2 respectively andduring remission was 78.8,67,85,80 respectively.Serum adiponectin(μg/ml) in obese control subjects (3.25 ± 0.65 μg/ml) washighly significant lower than that in nonobese control subjects(10.51 ± 1.55μg/ml), (P-value < 0.001).Also serum adiponectin(μg/ml) is highly significantlower in obese asthmatics during attack (1.58 ± 0.724 μg/ml) than that in obeseSummary

asthmatics during remission (2.08 ± 0.74 μg/ml) and that in obese control subjects(3.25 ± 0.65 μg/ml), (P-value < 0.001).Serum adiponectin(μg/ml) was significantlyhigher in nonobese asthmatics during remission (9.49 ± 2.49 μg/ml) than that innonobese asthmatics during attack (7.89 ± 2.7 μg/ml) and both are lower than thatin nonobese control subjects , (p-value < 0.05 ).Serum adiponectin (μg/ml) was highly significant lower in obese asthmaticsduring attack (1.58 ±0.72 μg/ml) than that in obese asthmatics during remission(2.08 ± 0.74 μg/ml), (P-value < 0.001) and highly significant higher in nonobeseasthmatics during attack (7.89 ± 2.7 μg/ml) than that in nonobese asthmatics duringremission (9.49 ± 2.49 μg/ml), (P-value < 0.001).The results showed highly significant positive correlation between serumadiponectin (μg/ml) and FVC (%Pred) (r = 0.9, P < 0.005) , highly significantpositive correlation with FEV1(%Pred) (r = 0.89,P < 0.005),significant positivecorrelation with FEF25-75 (%Pred) (r = 0.84,P < 0.05) and nonsignificant negativecorrelation with FEV1/FVC (r = - 0.43, P > 0.05) in obese control subjects.Alsothere was significant positive correlation between serum adiponectin (μg/ml)and FVC (%Pred) (r = 0.91, P-value < 0.05) , FEF25-75(%Pred) (r = 0.76,P-value < 0.05),highly significant positive correlation with FEV1(%Pred)(r = 0.93, P-value < 0.005) and nonsignificant positive correlation with FEV1/FVC(r = 0.61, P-valu > 0.05) in nonobese control subjects.There was nonsignificant positive correlation between the changes in serumadiponectin (μg/ml) and the changes in FVC(%pred) (r = 0.27, P-value > 0. 05)and highly significant positive correlation with changes in FEV1(%pred) (r=0.82,P-value< 0.001),significant positive correlation with FEV1%(r = 0.56, P-value <0.05) and highly significant positive correlation with FEF 25-75(r = 0.71, P-value< 0.001) in obese asthmatics.Also there was significant positive correlationSummary

between the changes in serum adiponectin (μg/ml) and the changes in FVC(%pred)(r = 0.45, P-value < 0.05), highly significant positive correlation withFEV1(%pred) (r = 0.7, P-value < 0.005),and nonsignificant negative correlationwith changes in FEV1% (r = - 0.13, P-value > 0. 05) and significant positivecorrelation with the changes in FEF25-75 (r = 0.53, P-value < 0.05) in nonobeseasthmatics.The results showed significant positive correlation between age (years) andserum adiponectin (μg/ml) in obese (r = 0.81, P-value < 0.05) and nonobese controlsubjects (r = 0.87, P-value < 0.05).Also there was highly significant positivecorrelation between age (years) and serum adiponectin (μg/ml)in obese asthmaticsduring attack(r = 0.91, P-value < 0.001) and remission(r = 0.88, P-value <0.001).There was highly significant positive correlation between age (years) andserum adiponectin (μg/ml) in nonobese asthmatics during attack(r = 0.91, P-value< 0.001) and remission (r = 0.92, P-value < 0.001).Serum adiponectin (μg/ml) level was significantly higher in obese (3.7 ± 0.58μg/ml) and nonobese control females (11.5 ±1.21 μg/ml) than that in obese (2.8±0.34 μg/ml) and nonobese control males (9.1± 0.057 μg/ml),( P-value <0.05).Alsothere was highly significant higher serum adiponectin (μg/ml) level in obeseasthmatic females(2.3 ± 0.5 μg/ml) than that in obese asthmatic males (1.1 ± 0.34μg/ml), during attack, (P-value < 0.001) and highly significant higher serumadiponectin (μg/ml) level in obese asthmatic females (2.7 ± 0.51 μg/ml) than thatin obese asthmatic males(1.6 ± 0.43 μg/ml) during remission, (P-value <0.001),there was highly significant higher serum adiponectin (μg/ml) level in nonobeseasthmatic females (9.8 ± 2.54 μg/ml) than that in nonobese asthmatic males(5.9 ± 0.43 μg/ml), during attack, (P-value <0.001). and highly significant higherserum adiponectin (μg/ml) level in nonobese asthmatic females (11.33 ±2.21Summary

μg/ml) than that in nonobese asthmatic males (7.6 ± 0.8 μg/ml) during remission,(P-value < 0.001).Results showed that there was highly significant negative correlation betweenBMI (kg/m2) and serum adiponectin (μg/ml) in obese,(r= - 0.91, P-value < 0.005)and nonobese control subjects (r= - 0.94, P-value <0.005).Also there washighly significant negative correlation between BMI(kg/m2) and serumadiponectin (μg/ml) in obese asthmatics during attack (r = - 0.91,P-value < 0.001)and remission (r = - 0.89, P-value < 0.001).There was highly significant negativecorrelation between BMI(kg/m2) and serum adiponectin (μg/ml)in nonobeseasthmatics during attack(r= - 0.98, P-value < 0.001) and remission (r = - 0.95,P-value < 0.001).