Metabolic stress and stress-limiting mechanisms in bronchial asthma combined with type 2 diabetes mellitus

Objective: to study the indicators of lipid peroxidation and the antioxidant system in the blood and moisture condensate of exhaled air in patients with AD combined with type 2 diabetes, and in the blood of these patients — total metabolites of nitric oxide. Materials and methods: the study involved 215 patients with persistent BA of moderate severity aged (38.6±2.4) years, including 88 men (40.9%), 127 women (59.1%). Among the examined patients with BA there were 64 — group I, persons with BA combined with type 2 diabetes — 151 (group II). The parameters of the lipid peroxidation system (LPS) in the blood serum were studied: malondialdehyde (MDA), diene conjugates (DC), and the antioxidant system (AOS) according to the activity of catalase and superoxide dismutase (SOD), the amount of total metabolites of nitric oxide (NOx), in the condensate of exhaled air moisture (KEAM) was determined general oxidant (GOA) and antioxidant (AOA) activity. Results: in patients with BA combined with type 2 diabetes, an increase in the concentration of POL products in the blood was revealed: MDA was 2.6 times (p<0.05) compared with the control group and 1.3 times (p<0.05) compared with the indicator in patients with AD, DC, respectively, 2.0 times (p<0.05) compared with the control group and 1.2 times (p<0.05) compared with I group. The activity of the enzymes AOS catalase and SOD in patients with comorbidity of BA and type 2 diabetes was found to be lower than in patients of group I. In the KEAM of patients with comorbidity of BA and type 2 diabetes, a significant increase in OOA and a decrease in OAA were noted. The concentration of NOx in the blood serum of group II patients was 1.6 times higher than in the control group (p<0.05), but 1.4 times lower than in patients with AD without comorbidity with type 2 diabetes (p<0.05). The direction of the revealed correlations between the products of POL in blood serum and KEAM confirmed the systemic nature of metabolic changes in the body of patients with AD, and their strength in group II patients — the negative effect of comorbid type 2 diabetes on the greater severity of these metabolic changes. Conclusions: the resulting changes in the state of LPS and AOS in the blood and KEAM of patients with BA combined with type 2 diabetes can be characterized as systemic metabolic stress, both components of which: oxidative and nitrosive are supported by insufficient stress-limiting mechanisms  — low activity of AOS enzymes and possible depletion of nitric oxide production, which should be reflected in the means of correcting metabolic disorders in patients with this comorbidity.

1. Kytikova O.Y., Antonyuk M.V., Gvozdenko T.A., Novgorodtseva T.Р. Metabolic aspects of the relationship of asthma and obesity. Obesity and metabolism. 2018;15(4):9-14. (In Russ.) DOI: 10.14341/omet9578

2. Pashkevich A.A., Serebryakova O.V. Analysis of genetic polymorphism of leptin (g2548a) in patients with a combination of asthma and diabetes type 2. Modern problems of science and education. 2023;(6):131-134. (In Russ.) DOI 10.17513/spno.33176

3. Stafeev A.N., Logvinenko N.I., Melnik A.V., Astrakov S.V. Bronchial asthma and comorbid diseases. Variants of no synthetases genetic polymorphisms. Modern problems of science and education. 2020;(4):43-52. (In Russ.) DOI: 10.17513/spno.30062

4. Alekseenko E.A., Bykov I.M., Lukonin I.A. The oxidative metabolism disorders in patients suffering from type II diabetes mellitus and diseases of the respiratory apparatus. Kuban scientific medical bulletin. 2017;1(162):7-11. (In Russ.) eLIBRARY ID: 29141486 EDN: YNSHBV

5. Gavrilov V.B., Mishkorudnaya M.M. Spektrofotometricheskoe opredelenie soderzhaniya gidroperekisei lipidov v plazme krovi. Laboratornoe delo. 1983;(3):33-36. (In Russ.) eLIBRARY ID: 21850675 EDN: SKECVT

6. Korolyuk M.A., Ivanova L.I., Maiorova I.G., Tokarev V.E. Metod opredeleniya aktivnosti katalazy. Laboratornoe delo. 1988;(1):16-19. (In Russ.) eLIBRARY ID: 21757023 EDN: SICVLT

7. Green LC, Wagner DA, Glogowski J, Skipper PL, Wishnok JS, Tannenbaum SR. Analysis of nitrate, nitrite, and [15N]nitrate in biological fluids. Anal Biochem. 1982;126(1):131-138. DOI: 10.1016/0003-2697(82)90118-x

8. Rebrova O.Yu. Statisticheskii analiz meditsinskikh dannykh. Primenenie paketa prikladnykh programm STATISTICA. Moskva: Mediasfera; 2002. ((In Russ.) eLIBRARY ID: 42430289 EDN: UISZQM

9. Churilova E.Yu., Salin V.N. Neparametricheskie metody obnaruzheniya vzaimosvyazi pokazatelei v sovremennykh statisticheskikh issledovaniyakh s ispol'zovaniem paketa prikladnykh programm STATISTICA. Innovatsionnoe razvitie ekonomiki. 2017;4(40):219-233. (In Russ.) eLIBRARY ID: 30102839 EDN: ZITGGZ

10. Pashkevich A.V., Serebryakova O.V. Clinical, laboratory and instrumental features of the combined course of bronchial asthma and type 2 diabetes mellitus. ENI Zabaikal'skii meditsinskii vestnik. 2023;(4):49-55. DOI: 10.52485/19986173_2023_4_49