The impact of coexisting metabolic syndrome on asthma control in patients diagnosed with asthma

Aims: Asthma is a disease characterized by diffuse and reversible narrowing of the airways, affecting approximately 300 million people worldwide. Metabolic syndrome, on the other hand, is a fatal endocrinopathy that begins with insulin resistance. Numerous studies have investigated the impact of metabolic syndrome on airway inflammation in patients with asthma. In this study, we aimed to investigate the coexistence of metabolic syndrome in patients followed up with a diagnosis of asthma and its impact on asthma control using the asthma control test (ACT). Methods: A total of 50 patients, including 10 men and 40 women aged between 18 and 70 years, who presented to the asthma outpatient clinic of Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital and were diagnosed with asthma, were included in the study. Participants completed a questionnaire assessing demographic characteristics and medical history. Subsequently, height, weight, waist circumference, and triceps skinfold thickness measurements were taken. Arterial blood pressure was measured, and blood samples were collected after 12 hours of fasting to evaluate serum triglyceride (TG), HDL, and fasting glucose levels, along with a complete blood count. Pulmonary function tests were performed, and participants responded to the short form of the International Physical Activity Questionnaire (IPAQ). Results: Upon evaluation, 30% of the cases were diagnosed with metabolic syndrome. Metabolic syndrome was diagnosed in 40% of male and 27.5% of female patients. Among the 50 participants, 16 (32%) were diagnosed with obesity, 19 (38%) with hypertension, and 1 (2%) with diabetes mellitus. The average duration of asthma follow-up was calculated as 10.8±8.7 years. The prevalence of metabolic syndrome was found to be higher in postmenopausal women compared to premenopausal women, whereas among women using oral contraceptives, the diagnosis of metabolic syndrome was lower than in non-users; however, this was not statistically significant (p>0.05). However, waist circumference measurements were significantly higher in those with metabolic syndrome compared to those without (p<0.05). A significant association was found between serum TG levels and metabolic syndrome diagnosis, while no significant relationship was observed for fasting blood glucose and serum HDL levels. Both systolic and diastolic blood pressure values were found to be higher in individuals with metabolic syndrome, with a statistically significant association between blood pressure values and the diagnosis of metabolic syndrome. According to the ACT results, 4 patente (8%) were under control, 17 (34%) were partially controlled, and 29 (58%) were uncontrolled. Among patients with metabolic syndrome, the forced expiratory volume in 1 second (FEV1) was found to be lower with borderline values. No significant association was found between physical activity levels and metabolic syndrome. Both groups, with and without metabolic syndrome, had low ACT scores, and no significant relationship was found between metabolic syndrome and ACT scores. Conclusion: Nonetheless, based on the findings of this study, we believe that metabolic syndrome should also be considered when planning treatment for asthmatic patients.