الفهرس 
BRONCHIAL ASTHMAOnly 14 pages are availabe for public view
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Abstract
Bronchial asthma is a chronic inflammatory disease characterized by bronchial hyperreactivity, reversible airway obstruction, and excessive mucus production that arises from an inappropriate stimulation of the immune system, especially by environmental aeroallergens.
Dyslipidemia, an abnormal lipid metabolism, is a well-established risk factor for cardiovascular diseases and has also been associated with disorders like rheumatoid arthritis, lupus and atherosclerosis. Its possible association with lung diseases is poorly elucidated.
Blood lipid levels in children are associated with asthma, airway obstruction, bronchial responsiveness and sensitization to aeroallergens. Asthma and allergies share certain features such as dyslipidemia with other chronic inflammatory disorders.
Several studies have examined the relationship of asthma with serum dyslipidemia in adults and children and reported positive, negative or no association.
This cross – sectional case control study was designed with the aim to investigate the presence of dyslipidemia in asthmatic children and study the relation between their lipid profile and the clinical profile of those children and their pulmonary function results. It included 60 previously diagnosed asthmatic children & adolescents from those regularly attending the clinic and diagnosed according to GINA 2015 guidelines. They were 33 male (55 %) and 27 female (45%) with mean age 12.37±2.107.
Ten age & sex matched healthy controls were also included serving as control group. They were 5 males (50%) and 5 females (501%) with mean age 13±1.491.
All included patients were subjected to:
We further subdivided our patients into 2 groups according to the level of fasting serum lipids using the 2011 Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents into:
group 1: asthmatic patients with dyslipidemia
Included 31 asthmatic patients with pathologically elevated serum TC or LDL-C or TG or pathologically low HDL-C.
group 2: asthmatic patients without dyslipidemia
Included 29 asthmatic patients with normal serum TC, LDL-C, HDL-C, TG.
All patients were subjected to detailed medical history laying stress upon age, Sex, exposure to second hand passive smoking, socioeconomic class using FAHMY and EL Sherbiny score & full history of asthma including age of onset of asthma, duration of the disease, therapeutic history including doses of controller therapy, history of other forms of atopy (allergic rhinitis and food allergy), history of exacerbations during the previous month.
Degree of severity of asthma was assessed retrospectively from the level of treatment required to control symptoms and exacerbations using GINA guidelines.
Level of asthma control was measured using Asthma control test for children 12 years old or older and Childhood Asthma Control Test for children 4 to 11 years old.
All the patients underwent General examination with stress on weight, height & body mass index & local chest examination.
As Regard laboratory investigation, Fasting serum lipid profile was done including Total cholesterol, low density lipoproteins (LDL), high density lipoproteins (HDL), triglycerides and serum total IgE was also done.
Blood sample was withdrawn after an overnight fast of 12 hours & performed on the same day at which sample was withdrawn.
All patients were subjected to spirometric pulmonary function test to measure:
• FEV1% of predicted, FVC % of predicted, FEV1/FVC ratio, MMEF 25-75% of predicted.
Abnormal FEV1% of predicted values were further subdivided graded according to American Thoracic Society Grades of severity.
The study showed that serum cholesterol level and serum triglyceride level were highly statistically significant among asthmatic patients in comparison to control while there was no significant statistical difference between both asthmatic patients and control as regard serum low density lipoproteins and serum high density lipoproteins.
Our study found that there is no statistical significant relation between serum cholesterol level and (age, duration of disease, body weight, body mass index, pulmonary function test parameters (FEV1%, FVC %, FEV1/FVC ratio, MMEF 25-75%)) among cases.
Our study found that there is high statistical significant relation between serum cholesterol level and serum total IgE
Our study found that there is no statistical significant relation between serum triglycerides and (age, duration of disease, pulmonary function test parameters (FEV1%, FVC %, FEV1/FVC ratio, MMEF 25-75%)) among cases.
Our study found that there is significant statistical relation between serum triglycerides and (body weight and body mass index and serum cholesterol).
There is no statistical significant relation between serum triglycerides and (serum LDL and serum HDL).
Our study found that there is no statistical significant relation between serum low density lipoprotein level (LDL) and (age, duration of disease, body weight and body mass index, pulmonary function test parameters (FEV1%, FVC %, FEV1/FVC ratio, MMEF 25-75%)) among cases.
There is high statistical significant relation between seum LDL level and (total IgE and serum cholesterol level).
Our study found that there is no statistical significant relation between serum high density lipoprotein level (HDL) and (age, duration of disease, body weight and body mass index) among cases.
Our study found that there is no statistical significant relation between serum HDL level and pulmonary function test parameters (FEV1%, FVC %, FEV1/FVC ratio, MMEF 25-75%) among cases but there is statistical significant relation between serum HDL level and FEV1 %.
There is no statistical significant relation between serum HDL level and (serum LDL level and total IgE).
There is high statistical significant relation between serum HDL level and serum cholesterol level.
Our study found that sex of our cases did not affect mean serum level of cholesterol, LDL, HDL and triglycerides.
Our study found that exposure to second hand passive smoking did not affect mean serum level of cholesterol, LDL, HDL and triglycerides.
Our study found that degree of severity of asthma did not affect mean serum level of LDL, HDL and triglycerides.
But mean serum level of cholesterol showed high statistical significant affection by degree of severity of asthma.
Our study found that level of control of asthma did not affect mean serum level of cholesterol, LDL, HDL and triglycerides.
Our study found that exacerbations through the last month did not affect mean serum level of cholesterol, LDL, HDL and triglycerides.
Our study found that coexistence of allergic rhinitis did not affect mean serum level of cholesterol, LDL, HDL and triglycerides.
Our study found that using inhaled corticosteroids did not affect mean serum level of cholesterol, LDL, HDL and triglycerides.
Our study found that using ICS/LABA did not affect mean serum level of cholesterol, LDL, HDL and triglycerides.
Our study found that there is no statistical significant difference between asthmatics with dyslipidemia and asthmatics without dyslipidemia as regard duration of asthma.
Our study found that there is no statistical significant difference between asthmatics with dyslipidemia and asthmatics without dyslipidemia as regard pulmonary function test parameteres.
Our study found that there is no statistical significant difference between asthmatics with dyslipidemia and asthmatics without dyslipidemia as regard serum total IgE.
Our study found that there is statistical significant difference between asthmatics with dyslipidemia and asthmatics without dyslipidemia as regard FEV1 grading.
Our study found that there is no statistical significant difference between asthmatics with dyslipidemia and asthmatics without dyslipidemia as regard sex.
Our study found that there is no statistical significant difference between asthmatics with dyslipidemia and asthmatics without dyslipidemia as regard exposure to second hand passive smoking.
Our study found that there is no statistical significant difference between asthmatics with dyslipidemia and asthmatics without dyslipidemia as regard level of control of asthma.
Our study found that there is statistical significant difference between asthmatics with dyslipidemia and asthmatics without dyslipidemia as regard degree of severity of asthma.