The Indian Journal of Chest Diseases and Allied Sciences

Register      Login

VOLUME 63 , ISSUE 1 ( January-March, 2021 ) > List of Articles

Original Article

Correlation of hs-CRP, Exhaled Nitric Oxide and Atopic Status in Non-Obese and Obese Bronchial Asthma Patients

Raj Kumar, Anil Kumar Mavi, Kamal Singh, Manoj Kumar

Keywords : Atopic status, Skin prick test, Aeroallergens, BMI, Inflammation

Citation Information : Kumar R, Mavi AK, Singh K, Kumar M. Correlation of hs-CRP, Exhaled Nitric Oxide and Atopic Status in Non-Obese and Obese Bronchial Asthma Patients. Indian J Chest Dis Allied Sci 2021; 63 (1):7-12.

DOI: 10.5005/ijcdas-63-1-7

License: CC BY-NC 4.0

Published Online: 18-11-2022

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Objectives: Obesity and asthma are the common conditions that describe the distinctive nature of inflammation. The high-sensitivity C-reactive protein (hs-CRP) and fraction of exhaled nitric oxide (FENO) levels are known to influence the atopic status. This study was undertaken to compare these inflammatory markers and atopic profile between non-obese and obese asthmatic patients. Methods: Two hundred asthma patients aged between 11-58 years were enrolled for this study and divided into two groups: non-obese [body mass index (BMI) <25 kg/m2) (n=100) and obese (BMI>30 kg/m2) (n=100)]. All the subjects were assessed for the pulmonary function test (PFT), hs-CRP from blood serum, FENO and skin prick test (SPT) against the battery of 58 common aero-allergens and subjects having at least one SPT positive were labelled as atopics. Results: Of these 200 patients, 135 (67.5%) were atopics [n=80 (59.3%) non-obese; and n=55 (40.7%) obese]. The BMI for the non-obese and obese group was 22.4 and 33.9 Kg/m2, respectively. The functional residual capacity percent (FRC%) of non-obese and obese were (111.2±24.6 versus 88.54±19.99 (P<0.001) and expiratory reserve volume (ERV%) predicted was (97.750±33.571 versus 70.9±24.8; P<0.001). Both FRC% and ERV% were significantly lower in the obese group. Levels of FENO of non-obese were significantly higher than the obese (38.08±3.13 versus 30.77±3.02; P=0.0685). The hs-CRP was significantly higher in obese atopics in comparison to non-obese (15.33±23.66 versus 21.60±45.35; P<0.001).


PDF Share
  1. Anne E, Fernando H, Aksay S, Cheryl MS, Richard EP. An American thoracic work shop report: obesity and asthma. Am Thorac Soc 2010;7:325–35.
  2. Visser M, Bouter LM, McQuillan GM, Wener MH, Harris TB. Low grade systemic inflammation in overweight children. Pediatrics 2001;107:E13.
  3. Jones RL, Nzekwu MM. The effects of body mass index on lung volumes. Chest 2006;130:827–33.
  4. National Task Force on the Prevention and Treatment of Obesity. Overweight, obesity, and health risk. Arch Intern Med 2000;160:898–904.
  5. Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH. The disease burden associated with overweight and obesity. JAMA 1999;282:1523–9.
  6. Golden MP, Swern A, Bird SS, Hustad CM, Grant E, Edelman JM. Influence of body mass index on the response of asthma controller agents. Eur Respir J 2006;27:495–503.
  7. Weisberg SP, McCann D, Desai M, Rosenbaum M, Leibel RL, Ferrante AW Jr. Obesity is associated macrophage accumulation in adipose tissue. J Clin Invest 2003;112:1796–30.
  8. Xu H, Barnes GT, Yang Q, Tan G Yang D, Chou CJ, et al. Chronic inflammation in fat plays a crucial role in the development of obesity-related insulin resistant. J Clin Invest 2003;112:821–30.
  9. GINA Report, Global Strategy for Asthma Management and Prevention [Internet]. [place unknown] The Global Initiative for Asthma (GINA); 2016 update 4.2MB pdf. Available from URL: www.ginaasthma.org Accessed on April 4, 2016.
  10. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al, ATS/ERS Task Force: Standardisation of lund function testing: standardization of spirometry. Eur Respir J 2005;26:319–38.
  11. Kumar R, Sharan N, Kumar M, Gaur SN. Pattern of skin sensitivity to various aero-allergens in patients of bronchial asthma and/or allergenic rhinitis in India. J Allergy Asthma Immunol 2012;26:66–72.
  12. American Thoracic Society, European Respiratory Society. ATS/ERS recommendation of standardized procedure for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide 2005. Am J Respir Crit Care Med 2005;171:912–30.
  13. Mishra V. Effect of obesity on asthma among adult Indian women. Int J Obes Relat Metab Disord 2004;28:1048–58.
  14. Celedon JC, Palmer LJ, Litonjua AA, Weiss ST, Wang B, Fang Z, et al. Body mass index and asthma in adults in families of subjects with asthma in Anqing China. Am J Respir Crit Care Med 2001;164:1835–40.
  15. Anandha KR, Nitesh G, Raj K. Impact of obesity on bronchial asthma in Indian population. Lung India 2014;31:121–6.
  16. Nystad W, Meyer HE, Nafstad P, Tverdal A, Engeland A. Body mass index in relation to adult asthma among 135,000 Norweign man and women. Epidemiol 2004;160:969–76.
  17. Shaheen SO, Sterne JA, Montgomery SM, Azima H. Birth weight, body mass index and asthma in young adults. Thorax 1999;54:396–402.
  18. Shawn D, Aaron, Katherine L, Louis-philippe B, Andrew MR, Hernandez P, Catherine L, Stephen K. Over diagnosis of asthma in obese and non-obese adults. Canadian Med Assoc J 2008;179:1121–31.
  19. Watson RA, Pride NB. Postural changes in lung volumes and respiratory resistance in subjects with obesity. J Appl Physiol 2005;98:512–7.
  20. Little S. Impact of obesity on respiratory function. Respirology 2011;17:43–49.
  21. Shinde PU, Irani FB, Heena K. The effect of body mass index on dynamic lung volumes. Int J Health Sc R 2014;4:42–46.
  22. Fredberg JJ. Airway smooth muscle in asthma: flirting with disaster. Eur Respir J 1998;12:1252–6.
  23. Ray CS, Sue DY, Bray G, Hanseb JE, Wasserman K. Effect of obesity on respiratory function. Am Rev Respir Dis 1983;128:501–6.
  24. Collins LC, Hoberty PD, Walker JF, Fletcher EC, Peiris AN. The effect of body fat distribution on pulmonary function test. Chest 1995;107:1298–302.
  25. Heena KG, Irani F, Shinde P. Effect of obesity on ventilator function of medical student. Int J Cur Res 2014;6:67–70.
  26. Lazarus R, Sparrow D, Weiss ST. Effects of obesity and fat distribution on ventilatory function: the normative aging study. Chest 1997;111:891–8.
  27. Scott HA, Gibson PG, Garg LM, Wood LG. Airway inflammation is augmented by obesity and fatty acid in asthma. Eur Respir J 2011;38:594–602.
  28. Hauber HP, Gotfried M, Newman K, Danda R, Servi RJ, et al. Effect of HFA-flunisolide on peripheral lung inflammation in asthma. J Allergy Clin Immunol 2003;112:58–63.
  29. Haley KJ, Sunday ME, Wigg BR, Kozakewich Hp, Reilly JJ, et al. Inflammatory cell distribution within and along asthmatic airways. Am J Respir Crit Care Med 1998;158:565–72.
  30. Simard B, Turcotte H, Marceau P, Biron S, Hould FS, et al. Asthma and sleep apnoea in patients with morbid obesity: outcome afterbariatric surgery. Obes Surg 2004;14:1381–8.
  31. Ozol D, Mete E. Asthma and food allergy. Curr Opin Pulm Med 2008;14:9–12.
  32. Von Mutius E, Schwartz J, Neas LM, Dockery D, Weiss ST. Relation to body mass index to asthma and atopy in children: The National Health and Nutrition Examination Study III. Thorax 2001;56:835–8.
  33. Tracy RP, Inflammation in cardiovascular disease: cart, horse, or both? Circulation 1998;97:2000–2.
  34. Visser M, Bouter LM, McQuillen GM, Wener MH, Harris TB. Elevated c-reactive protein levels in overweight and obese adults. JAMA 1999;282:2131–5.
  35. Qian FH, Zhang Q, Zhou LF, Liu H, Huang M, Zhang XL, et al. High-sensitivity c-reactive protein: a predictive marker in severe asthma. Respirology 2008;13:664–9.
  36. Olafsdottri IS, Gislason T, Thjodleifsson B, Olafsson I, Jogi R, et al. Creative protein levels are increased in non-alergic but not allergic asthma: a multicentre epidemiological study. Thorax 2005;60:451–4.
  37. Dweik RA, Boggs PB, Erzurum Sc, Irvin CG, Leigh MW, et al. American Thoracic society Committee on interpretation of exhaled nitric oxide levels (FENO) or clinical applications: An official ATS clinical practice guideline: Interpretation of exhaled nitric oxide levels of clinical application. Am J Respir Crit Care Med 2011;184:403–8.
  38. Van Rensen EL, Straathof KC, Veselic-Charvat MA, Zwinderman AH, Bel. EH, Sterk PJ. Effect of inhaled steroid on airway hyperresponsiveness, sputum eosinophis, and exhaled nitric oxide levels in patients with asthma. Thorax 1999;54:403–8.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.