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The aim of the investigation was to estimate the possibilities of using relative body mass index (RBMI) for determining age-and gender-specific aspects of nutritional status in children and adolescents with bronchial asthma (BA) of different severity degrees.Materials and Methods. The study involved 887 children and adolescents with BA of different severities, aged 5-17 years (61-215 months), of them 655 were boys. Their body mass index (BMI) was evaluated based on the Z-score criterion and nutritional status was determined as recommended by the World Health Organization (WHO). To unify nutritional status assessment in patients of different age and gender groups, there was introduced RBMI representing the ratio of the patient's BMI to gender-and age-specific median BMI value presented in the WHO reference data.Results. Nutritional status and its relation to BA were studied in children and adolescents using two parameters: the standard nutritional status indicator based on BMI Z-scores as recommended by WHO, and a new parameter, RBMI, representing the ratio of the patient's BMI to gender-and age-specific median BMI value recommended by WHO. No significant nutritional status differences were found in the studied sample of patients with various degrees of BA severity. There was revealed a tendency to a decrease in the proportion of children with normal body weight and an increase in the proportion of overweight children as BA severity increased, χ 2 =26.82; р=0.08. Conclusion. Using RBMI for assessment of BA patients makes it possible to significantly facilitate clinical data analysis and obtain new data unavailable when standard parameters are applied.Key words: bronchial asthma; nutritional status of children; obesity in asthma; body mass index; relative body mass index.

Allergic rhinitis (AR) and allergic rhinosinusitis (ARS) are typical upper airway pathologies (UAP) in children with bronchial asthma (BA) frequently accompanied with nasal obstructive diseases (NOD). In order to establish the effect of NOD on correlations between nasal and synonasal symptoms with clinical assessments of asthma control, 82 children, 9.8 [8.9; 10.7] years old, with atopic BA were assessed using ACQ-5 for the BA control level, TNSS for nasal symptoms, and SNOT-20 for synonasal quality of life in combination with rhinovideoendoscopy for NOD. All patients had AR/ARS; in 76.3% (63/82) of children, UAP had a multimorbid character with the presence of NOD. Significant correlations were found between ACQ-5 and TNSS (R=0.40, p < 0.0001) and ACQ-5 and SNOT-20 (R=0.42, p < 0.0001). Correlations between TNSS/ACQ-5 and SNOT-20/ACQ-5 were higher in patients who do not have a combination of AR/ARS with NOD (R=0.67, p=0.0012; R=0.50, p=0.022, resp.) than in patients who have AR/ARS combined with NOD (R=0.30, p=0.015; R=0.26, p=0.04, resp.). Thus, the association of BA control level with the expression of nasal and synonasal symptoms is higher in children who do not have multimorbid UAP.

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Influence of bronchial asthma (BA) severity on physical development in children patients was evaluated in comparison with healthy population. Materials and Methods. 1042 children and adolescents (768 boys) with atopic BA were evaluated. All children underwent standard examination in a clinical setting, including anthropometry. The control group included 875 healthy children of a comparable age (423 boys). Results. The fraction of patients with the normal, lower, and increased height among the whole group of patients with BA is close to the corresponding values in the healthy population (χ2 = 3.32, p = 0.65). The fraction of BA patients with the reduced physical development is increased monotonically and significantly when the BA severity increases: healthy group, 8.2% (72/875), BA intermittent, 4.2% (6/144), BA mild persistent 9% (47/520), BA moderate persistent, 11.7% (36/308), and BA severe persistent, 24.3% (17/70) (χ2 = 45.6, p = 0,0009). Conclusion. The fraction of the children with the reduced height is increased monotonically and significantly in the groups of increasing BA severities. At the same time, the fraction of such children in groups of intermittent and mild persistent BA practically does not differ from the conditionally healthy peers.