Bronchial asthma as a pathophysiological factor of sarcopenia onset
Background. Under bronchial obstruction caused by the bronchial asthma (BA), one may observe a change in blood gas factor, development of oxidative stress, electrolyte and metabolic imbalance, which lead to lung emphysema and chronic respiratory failure formation. This was accompanied by changes in respiratory muscles, particularly in the diaphragm, which are characterized by an advanced atrophy and a further loss of muscle strength and mass. The question arises to which extent BA affects the state of skeletal muscles as they determine tolerance for physical activity and quality of life in these patients. The purpose was to determine functional capacity of skeletal muscles and frequency of sarcopenia in patients with BA. Materials and methods. Seventy people aged 47.82 ± 13.54 years were examined. The first group included 35 persons who had BA, while the second group consisted of 35 healthy persons. An 8-step test for walking speed was applied to assess the functional capacity of skeletal muscles. The skeletal muscle power was evaluated with the help of spring hand dynamometer. Circumference of the tibia determined the criterion of satisfactory muscle mass. Quality of life was assessed by means of O.S. Chaban’s questionnaire. Results. When evaluating skeletal muscle power, wrist dynamometry was reduced by 22 % in case of severe BA compared to moderate BA, the corresponding index made 29 % when compared to the wrist dynamometry of healthy persons. An inverse correlation was found between BA severity and wrist strength in females (r = –0.65) and males (r = –0.3); walking speed in females (r = –0.72) and males (r = –0.6); circumference of the tibia in females (r = –0.17) and males (r = –0.28). A decrease in skeletal muscle power and tolerance for physical activity were associated with the loss of muscle component among 80 % of patients with BA. Conclusions. Sarcopenia was diagnosed in 5.71 % of persons from the control group, and in 25.71 % of patients with BA. Depending on BA severity and the age of patients, sarcopenia was detected in 9.5 % of patients who had moderate BA, and in 35.71 % of patients with severe BA; in 10.53 % of persons under the age of 45, and in 31.25 % of those over 45.
Global Asthma Network (GAN). The Global Asthma Report 2014. Auckland, New Zealand: Global Asthma Network; 2014. 93 p.
Journey through the steps of bronchial asthma: proceeding of the XI National Asthma Congress. Ukrainian Pulmonology Journal. 2018;(1):39-42. (in Ukrainian).
Feshchenko YuІ, Iashyna LO, Nazarenko KV, Polianska M O. Clinical efficacy of tiotropium bromide in basic therapy in patients with asthma-COPD overlap. Astma ta alergіa. 2017;(4):7-14. (in Ukrainian).
Feshchenko YuІ, Primushko NA, Parhomenko NV, et al. Restoration of physical activity in patients with asthma. Astma ta alergіa. 2017;(1):17-22. (in Ukrainian).
Uchmanowicz B, Panaszek B, Uchmanowicz I, Rosińczuk J. Clinical factors affecting quality of life of patients with asthma. Patient Prefer Adherence. 2016 Apr 19;10:579-89. doi: 10.2147/PPA.S103043.
Windisch W. Noninvasive positive pressure ventilation in COPD. Breathe. 2011;8(2):115-123. doi: 10.1183/20734735.011511.
Feshchenko YuІ, Yashina LO, Іgnatieva VІ, Sidun GV. Respiratory muscle function in patients chronic obstructive pulmonary disease, bronchial asthma with obstructive sleep apnea syndrome. Ukrainian Pulmonology Journal. 2005;(3 Suppl):82-84. (in Ukrainian).
Lemeshevskaya SS, Makarevich AE, Pochtavtsev AYu. Ultrasonic estimation of respiratory muscles (RM) in men with chronic obstructive pulmonary disease (COPD). Medical Journal. 2012;(41):83-90. (in Russian).
Garas MN, Bilous TM, Lekhkun GV. Signs of inflamation in the airways in children with exercise-induced bronchial asthma. Inter collegas. 2017;4(1):14-19.
Hall DT, Ma JF, Marco SD, Gallouzi IE. Inducible nitric oxide synthase (iNOS) in muscle wasting syndrome, sarcopenia and cachexia. Aging (Albany NY). 2011 Aug;3(8):702-15. doi: 10.18632/aging.100358.
Pertseva TA. Muscular dysfunction in COPD: reassessment of the problem, new treatment options. Zdorov’ja Ukrai'ny: Pul'monologija, Alergologija, Rynolaryngologija. 2008;(3-1):17-19. (in Russian).
Povoroznyuk VV, Dzerovych NI, Synieok LL, Romanenko MS. Diagnosis and prevention of sarcopenia. Bolʹ, sustavy, pozvonočnik. 2017;7(4):179-193. doi: 10.22141/2224-1507.7.4.2017.121230. (in Ukrainian).
Ministry of Нealth of Ukraine. Order on March 19, 2007 № 128. On Adoption of Clinical Protocols of Medical Care in Pulmonology. Available from: https://zakon.rada.gov.ua/rada/show/v0128282-07?lang=uk. Accessed: March 19, 2007. (in Ukrainian).
Chaban OS, Haustova OO, Bezshejko VG, Moskalenko OV. Validation of life quality assessment scale. Ukrains'kyi Visnyk Psykhonevrolohii. 2017;25(90):159-160. (in Ukrainian).
Schakman O, Gilson H, Thissen JP. Mechanisms of glucocorticoid-induced myopathy. J Endocrinol. 2008 Apr;197(1):1-10. doi: 10.1677/JOE-07-0606.
Gayan-Ramirez G, Decramer M. Mechanisms of striated muscle dysfunction during acute exacerbationsof COPD. J Appl Physiol (1985). 2013 May;114(9):1291-9. doi: 10.1152/japplphysiol.00847.2012.
Izquierdo Alonso JL, Rodríguez Glez-Moro JM. The excessive use of inhaled corticosteroids in chronic obstructive pulmonary disease. Arch Bronconeumol. 2012 Jun;48(6):207-12. doi: 10.1016/j.arbres.2012.01.002.
Battaglia S, Cardillo I, Lavorini F, Spatafora M, Scichilone N. Safety considerations of inhaled corticosteroids in the elderly. Drugs Aging. 2014 Nov;31(11):787-96. doi: 10.1007/s40266-014-0213-1.
Prosvetov YuV, Barinov SS, Boev SS, Yatsenko OA. Bronchial asthma in the elderly: a review of clinical studies. Astma ta alergіa. 2018;(1):48-56. (in Russian).
Laghi F, Tobin MJ. Disorders of the respiratory muscles. Am J Respir Crit Care Med. 2003 Jul 1;168(1):10-48. doi: 10.1164/rccm.2206020.
Wouters EF, Groenewegen KH, Dentener MA, Vernooy JH. Systemic inflammation in chronic obstructive pulmonary disease: the role of exacerbations. Proc Am Thorac Soc. 2007 Dec;4(8):626-34. doi: 10.1513/pats.200706-071TH.
Pertseva TA, Konopkina LI, Boguslavskaya EV. Evaluation of functional state of respiratory muscles in patients with chronic obstructive pulmonary diseases in the formation of individual rehabilitation programs. Ukrainian Pulmonology Journal. 2004;(3):31-32. (in Russian).
Garcia-Rio F, Lores V, Mediano O, et al. Daily physical activity in patients with chronic obstructive pulmonary disease is mainly associated with dynamic hyperinflation. Am J Respir Crit Care Med. 2009 Sep 15;180(6):506-12. doi: 10.1164/rccm.200812-1873OC.
Waschki B, Kirsten A, Holz O, et al. Physical activity is the strongest predictor of all-cause mortality in patients with COPD: a prospective cohort study. Chest. 2011 Aug;140(2):331-342. doi: 10.1378/chest.10-2521.
Feshchenko YuІ, Iashyna LO, Nazarenko KV, Opіmakh SG. Exercise testing influence on pulmonary ventilation parameters in patients with bronchial asthma, chronic obstructive pulmonary disease and their combination. Astma ta alergia. 2017;(2):7-12. (in Ukrainian).
Lemeshevskaya SS. Quality of life in men with chronic obstructive pulmonary disease. Medical Journal. 2012;(41):90-94. (in Russian).
Masіk NP. Quality of life and the risk of osteoporosis in patients with chronic obstructive pulmonary disease. Ukrainian Therapeutical Journal. 2016;(1):68-74. (in Ukrainian).
Van Eeden SF, Sin DD. Chronic Obstructive Pulmonary Disease: A Chronic Systemic Inflammatory Disease. Respiration. 2008;75(2):224-38. doi: 10.1159/000111820.
Copyright (c) 2020 N.P. Masik, S.I. Ponina
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2020