Objective To observe the correlationship of serum leptin,adiponectin,Th1/Th2 cytokine and symptom severity in obese adult asthma patients,and investigate the pathogenesis of obese adult asthma.Methods From July to December in 2016,100 patients with asthma in the People's Hospital of Zhuhai,and 50 cases of healthy physical examination in the same period were studied.According to body mass,50 cases were divided into obese asthma group (A group),normal body mass asthma group(B group),obesity physical examination group (C group) and normal body mass physical examination group (D group),with 25 cases in each group.The serum leptin,adiponectin,INF-γand IL-4 were detected using ELISA,as well as did the concurrent pulmonary function and ACT.The correlationship of serum leptin and adiponectin,INF-γ,IL-4,pulmonary function and ACT were evaluated.Results The serum leptin,adiponectin,IFN-γ,IL-4 and IFN-γ/IL-4 in A group were (9.67 ±2.86) μg/L,(8.03 ± 3.69) mg/L,(83.69 ± 25.11) ng/L,(22.40 ± 10.92) ng/L,(4.67 ± 2.63),respectively,which in B group were (5.98 ± 3.03) μg/L,(12.30 ± 5.41) mg/L,(41.88 ± 24.25) ng/L,(7.10 ± 7.83) ng/L,(1.20 ± 0.83),respectively,which in C group were (7.02 ± 3.36) μμg/L,(11.52 ± 4.52) mg/L,(37.49 ±25.33) ng/L,(21.25 ± 9.65) ng/L,(2.00 ± 1.13),respectively,which in D group were (4.55 ± 2.33) μg/L,(15.13 ± 5.28) mg/L,(34.37 ± 12.46) ng/L,(21.25 ± 9.65) ng/L,(1.87 ± 1.21),respectively,the differences among the four group were statistically significant(F =19.435,13.114,33.252,23.250,31.750,all P ＜ 0.05);The leptin levels showed a negative correlation with ACT and FEV1 ％ Pred(r =-0.501,-0.384,all P ＜ 0.05),but a positive correlation with IFN-γand IFN-γ/IL-4(r =0.446,0.423,all P ＜ 0.05),and no correlation with IL-4 (r =-0.189,P ＞ 0.05).The serum adiponectin in A group was lower than that in B group,C group and D group (Z =3.207,t =3.532,5.520,all P ＜ 0.05),and showed a positive correlation with ACT and FEV1 ％ Pred (r =0.361,0.466,all P ＜ 0.05);and showed no correlation with INF-γ,IL-4 and IFN-γ/IL-4 (r =-0.155,0.108,-0.161,all P ＞ 0.05).Conclusion The serum leptin in obese asthma patients has a higher levels and a positive correlation with clinical severity,and probably play a role in airway hyperresponsiveness by Th1 cytokine mediating.The serum adiponectin has a negative correlation with clinical severity,but no correlation with Th1/Th2 cytokine.

ObjectiveTo systematically evaluate the effects of threshold inspiratory muscle training (TIMT) on respiratory function, motor function and quality of life in patients with chronic obstructive pulmonary disease (COPD). MethodsRandomized controlled trials (RCT) about the effects of TIMT on dyspnea, quality of life, motor function and inspiratory muscle strength for COPD patients were retrieved from PubMed, EBSCO, Web of Science, Ovid, Cochrane Library, SinoMed, CNKI, VIP, since establishment to September, 2020. Two researchers independently screened literatures, extracted data and evaluated the methodological quality. A meta-analysis was performed using RevMan 5.3. ResultsA total of 30 RCTs involving 2 060 patients were included. TIMT could obviously improve the maximum inspiratory pressure (MD = 10.68, 95%CI 7.43 to 13.92, P < 0.001), optimize the results of 6-minute Walking Test (MD = 24.62, 95%CI 9.09 to 40.15, P = 0.002), the St George's Respiratory Questionnaire (MD = -3.08, 95%CI -5.84 to -0.33, P = 0.03), the modified Medical Research Council Dyspnea Scale (MD = -0.30, 95%CI -0.52 to -0.07, P = 0.01) and Borg score (MD = -0.84, 95%CI -1.24 to -0.44, P < 0.001). TIMT could also improve the forced expiratory volume in one second (MD = 0.11, 95%CI 0.04 to 0.19, P = 0.003) and the forced expiratory volume in one second in predicted (MD = 3.72, 95%CI 2.62 to 4.82, P < 0.001). There was no significant difference in the COPD Assessment Test (MD = -1.14, 95%CI -2.32 to 0.03, P = 0.06) or forced vital capacity (MD = 0.07, 95%CI -0.12 to 0.25, P = 0.49). ConclusionTIMT can improve the inspiratory muscle strength, alleviate the symptoms of dyspnea, and improve the lung function and the quality of life for COPD patients.