The Effects of Aquatic Exercise on Pulmonary Function in Patients with Spinal Cord Injury

[Purpose] The purpose of this study was to determine the effects of aquatic exercise on pulmonary function of patients with spinal cord injury. [Subjects] The subjects were randomly allocated to an aqua group (n=10) and a land group (n=10). [Methods] Both groups trained for 60 minutes, 3 times a week for 8 weeks. Pulmonary function was assessed by measuring the forced vital capacity (FVC), forced expiratory flow rate (FER), force expiratory volume at one second (FEV₁) and force expiratory volume at one second/forced vital capacity (FEV₁/FVC). [Results] Following the intervention, the aqua group showed significant changes in FVC, FER, FEV₁, and FEV₁/FVC. The land group showed only significant differences FER. [Conclusion] The results of this study suggest the effects on the aqua group were significantly higher than those on the land group in patients with spinal cord injury.Key words: Spinal cord injury, Aqua, Pulmonary function     

Spirometric reference values in Estonian schoolchildren

This study was conducted to describe the relationship between anthropometric parameters and lung function in Estonian children, to determine the reference values for spirometry, and to compare these results with other data sets. The results are based on 1170 healthy non‐smoking children (643 girls and 527 boys), aged 6–18 years. The spiroanalyser Pneumoscreen II (Jaeger) was used to register dynamic lung parameters. Natural logarithmic values of lung volumes, standing or sitting height and age were used in the final regression model. Prediction equations for forced vital capacity (FVC), forced expiratory volume in 1 s (FEV₁), peak expiratory flow, forced expiratory flows when 50 and 75% of FVC has been exhaled, and mean forced expiratory flow over the middle 50% of the FVC for both sexes are presented. In comparison with recent data from European children the reference values were close for FVC, the differences were bigger for FEV₁ and forced expiratory flows, especially in taller children.     

Analysis of changes in pulmonary functions at rest following humidity changes

[Purpose] The purpose of this study was to compare the effect of humidity changes on the values of pulmonary function at rest. [Subjects and Methods] This study was conducted with 30 young adults (9 males, 21 females; mean age 19.4 years). Participants’ mean height was 165.1 cm, and their mean weight was 60.2 kg. The experimental setting was a laboratory in which temperature was fixed at 25 °C. Using a humidifier, relative humidity was successively to adjusted 25%, 50%, and 90%, and pulmonary were measured functions at each level. Using a spirometer, forced vital capacity (FVC), forced expiratory volume in one second (FEV₁), expiratory reserve volume (ERV), and tidal volume (TV) were measured, and the results were compared and analyzed. [Results] Controlling for temperature, FVC and FEV₁ showed statistically significant differences among different levels of relative humidity, but FEV₁/FVC, TV, and ERV showed no significant difference. [Conclusion] In the case of exercises that require large respiration volumes, such as aerobic exercises or exercise load tests, it is recommended that higher than normal humidity levels should be maintained.Key words: Pulmonary function, Humidity, Temperature     

Effects of Bupivacaine Versus Levobupivacaine on Pulmonary Function in Patients With Chronic Obstructive Pulmonary Disease Undergoing Urologic Surgery: A Randomized, Double-Blind, Controlled Trial

Background

There are limited data to determine the impact of subarachnoid blockade with local anesthetics on perioperative pulmonary function. The effects of local anesthetics used in spinal anesthesia are very important in terms of respiratory function in patients with chronic obstructive pulmonary disease (COPD).

Objective

The aim of this study was to evaluate the effects of bupivacaine versus levobupivacaine on pulmonary function in patients with COPD undergoing urologic surgery.

Methods

Patients were randomized into 2 groups: group B (n = 25) received 3 mL of hyperbaric 0.5% bupivacaine; group L (n = 25) received 3 mL of isobaric 0.5% levobupivacaine. Both agents were administered intrathecally. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV₁), peak expiratory flow rate (PEFR), vital capacity (VC), and FEV₁/FVC ratio were measured using spirometry 10 and 30 minutes after spinal anesthesia and 30 minutes after completion of the operation. An arterial blood gas test was performed before and after spinal anesthesia.

Results

Fifty male patients aged 40 to 80 years completed the study. There were no differences in the results of preoperative and postoperative FVC, FEV₁, PEFR, VC, FEV₁/FVC ratio, and arterial blood gas between the bupivacaine (n = 25) and levobupivacaine (n = 25) groups. However, patients who took bupivacaine showed a significant decrease in intraoperative PEFR at 30 minutes compared with baseline, a result not seen in patients who took levobupivacaine (P = 0.036 and P = 0.282, respectively).

Conclusions

In 50 patients with moderate COPD undergoing urologic surgery, hyperbaric bupivacaine caused a decrease in intraoperative PEFR compared with baseline because of higher level block; however, the effects of hyperbaric bupivacaine and isobaric levobupivacaine on pulmonary function in these patients showed equally effective potencies for spinal anesthesia.     

优质护理干预对小儿哮喘雾化治疗依从性

目的 观察优质护理干预对小儿哮喘雾化治疗依从性及肺功能的影响.方法 将本院收治的哮喘患儿50例随机分为观察组及对照组,每组各25例.所有患儿均行同规格雾化方式治疗,对照组实施传统方式护理,观察组实施优质护理干预措施,观察对比2组小儿哮喘患者的症状消失时间、血氧饱和度、肺功能[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、最大呼气峰流速(PEFR)]以及用药依从性情况.结果 观察组患儿咳嗽、哮喘等症状消失显著短于对照组,血氧饱和度高于对照组,差异均有统计学意义(P<0.05);护理干预前, 2组FEV1、FVC、PEFR检测指标水平差异无统计学意义(P>0.05);护理干预后, 2组小儿哮喘患者的FEV1、FVC以及PEFR指标水平均有显著改善,且观察组患者肺功能改善情况优于对照组,差异具有统计学意义(P<0.05);观察组总依从率高于对照组,差异具有统计学意义(P<0.05).结论 对小儿哮喘雾化治疗实施优质护理干预能够明显缓解哮喘、咳嗽症状,缩短治疗和住院时间,提升患儿治疗依从性,改善肺功能指标水平,应用效果显著,值得进一步应用推广.     

Diagnostic role of residual volume in paediatric patients with chronic symptoms of the lower airways

In bronchial asthma, measurement of absolute lung volumes may reveal lung dysfunction more readily than forced expiratory spirometry. Sixty-one children (aged 4–16 years) with mild to moderate bronchial asthma and 35 children (aged 7–16 years) with other symptoms of the lower airways (OSLA) were studied, and the plethysmographic results were compared with data obtained from 36 healthy volunteers aged 6–16 years. In the first test session, repeatability of forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), residual volume (RV), functional residual capacity (FRC) and total lung capacity (TLC) were good. Control subjects were also tested the next day, and intra-subject variability of repeat pulmonary function testing was in the normal range. The FEV₁/FVC ratio was significantly higher in control subjects than in patients with asthma or OSLA, but only the decrease in RV after bronchodilator challenge separated patients with asthma from patients with OSLA. Changes in FEV₁ and RV after bronchodilator challenge had a significant, although low, inverse correlation. An increase of ≥ 5% in FEV₁ had a positive predictive value of 44% and a negative predictive value of 68% for the clinical diagnosis of bronchial asthma; for a decrease of ≥ 24% in RV, the figures were 86% and 71% respectively. The support of baseline absolute lung volumes on clinical decision-making is not necessarily great. Bronchodilator response, particularly in RV, is more pertinent and may enhance the detection of reversible lung dysfunction.     

Single-breath counting: a pilot study of a novel technique for measuring pulmonary function in children

Introduction

Although peak expiratory flow rate is the conventional way to measure asthma severity in adults, its use is problematic in children because it is effort dependent. Forced expiratory volume in 1 second (FEV₁) and the ratio of FEV₁ to forced vital capacity (FEV₁/FVC) are more accurate, but generally not available in the emergency department (ED). A better test is needed. Single-breath counting (SBC) is the measurement of how far an individual can count in a normal speaking voice after a maximal effort inhalation. The count is in cadence to a metronome set at 2 beats per second. Previous work has suggested that SBC correlates with standard measures of pulmonary function in adults. However, it has never been tested in children.

Objectives

The aims of this study are to determine if SBC can be easily performed by children and to assess the correlation between SBC and standard measures of pulmonary function in a pediatric population.

Methods

This was a prospective observational study of a convenience sample of children presenting to the pulmonary clinic for scheduled pulmonary function testing (PFT). Peak expiratory flow rate, FEV₁, FVC, forced expiratory flow 25% to 75%, and FEV₁/FVC were measured and recorded. After PFT, subjects were asked to perform SBC. Three attempts were allowed, and the average was recorded. Correlation was determined by the Pearson coefficient.

Results

Sixty-seven children (ages 5-18 years, 64% male) were enrolled. All were able to understand and complete the testing. Indications for PFT included asthma and/or allergies (n = 44), cystic fibrosis (n = 9), and other chronic diseases (n = 14). The correlations (r) of SBC to peak expiratory flow rate, FEV₁, FVC, forced expiratory flow 25% to 75%, and FEV₁/FVC were 0.55, 0.66, 0.71, 0.44, and −0.29, respectively (P < .05 for all results).

Conclusion

Single-breath counting is easy to perform in children, seems to correlate well with standard measures of pulmonary function, and shows promise for measuring asthma severity in children. Further work to define the range of reference SBC values (as a function of age and/or body size) and an evaluation of the utility of SBC in an ED population of acute asthmatics is indicated.     

不同剂量甲基强的松龙治疗重症哮喘的效果

目的评价不同剂量甲基强的松龙（甲强龙）治疗重症哮喘的效果。方法将60例重症哮喘病人随机分为A、B组,分别静脉应用甲强龙40、60mg,均为每8h注射1次,平均治疗3～5d,观察两组病人的临床疗效、肺功能改善及并发症情况。结果两组治疗前后最大呼气流量、用力肺活量、一秒钟用力呼气容积差异有显著性（t=10．74～19．65,P均〈0．01）;两组间治疗效果比较差异无显著性（H=0．068,P〉0．05）;B组并发症明显多于A组,差异有显著性（x^2=11．52,P〈0．05）。结论甲强龙40mg,每8h注射1次治疗重症哮喘病人较为适宜。     

Impaired pulmonary function is a risk predictor for sudden cardiac death in men

Abstract

Objectives. Little is known about the association of reduced pulmonary function and the risk of sudden cardiac death (SCD). Our aim was to examine the relation of forced expiratory volume (FEV₁), forced vital capacity (FVC), and the ratio of FEV₁ to FVC with SCD in a population-based sample of men.

Methods. This study was based on 1250 men 42–60 years of age without chronic obstructive pulmonary disease, asthma, and lung cancer. During the 20-year follow-up, 95 SCDs occurred. FEV₁, FVC, and ratio of FEV₁ to FVC were used as lung function tests.

Results. As a continuous variable, each 10% increase in the percentage predicted FEV₁ was associated with 18% (adjusted risk 0.82, 95% CI 0.73–0.93, P < 0.002) reduced risk for SCD. Subjects with most reduced (lowest quintile) FEV₁ had a 3.5-fold increased risk for SCD (95% CI 1.42–8.41, P = 0.006), after adjustment for conventional risk factors. Similar results were observed with FVC. The results remained statistically significant among non-smokers and smokers respectively.

Conclusion. Our study shows that reduced lung function is a robust predictor of SCD in middle-aged men. Lung function test may be useful in risk stratification for SCD in general population.     

Efficacy of Ipratropium Bromide in Acute Childhood Asthma: A Meta-analysis

Purpose: To determine whether inhaled ipratropium bromide provides an additive, clinically important improvement in children with acute asthma who are being treated with β₂-agonists. Methods: An English-language literature search was conducted employing MEDLINE (1966 to 1992), Science Citation Index (1986 to 1992) using key citations, bibliographic reviews of primary research and review articles, and correspondence with authors of recent articles. After independent review by two observers, six studies were selected on the basis of prespecified selection criteria. Two observers independently assessed the selected papers by using explicit methodologic criteria for evaluating the quality of studies dealing with therapeutic intervention. Results: None of the six studies found a significant difference in clinical rating score, admission rate, or length of stay in hospital between the ipratropium bromide and the control groups. The three studies with the highest methodologic validity measured the change in percentage predicted forced expiratory volume in 1 second (FEV₁) from baseline to 60 minutes. The pooled effect size (95% CI) for these studies was 0.88 (0.42–1.34), which translates to an improvement in percentage predicted FEV₁ over the control group of 12.5% (95% CI, 6.6–18.4). In a subset of 23 children who had severe airway obstruction, peak expiratory flow rate (PEFR) responded better to a β₂-agonist alone (p = 0.007). Conclusion: The existing evidence reveals that the addition of ipratropium bromide to a β₂-agonist offers a statistically significant improvement in percentage predicted FEV₁ but no clinical improvement. As it may cause deterioration in PEFR in severely asthmatic children, ipratropium bromide should not be used universally for acute childhood asthma until further research determines the clinical significance of these spirometric changes.     

Characteristics of subjects with a high frequency of emergency visits for asthma

The determinants of frequent visits to the emergency department (ED) for asthma were evaluated in 30 patients who made 2 or more ED visits for asthma (mean, 3.1; range, 2 to 9) over a period of 1 year. They were matched for age, sex, and medication with a control group of asthmatic patients who had made no ED visits within the same period. Evaluation included measurements of expiratory flows (baseline FEV₁; PEFR 4 times daily for 3 weeks), airway responsiveness to methacholine, perception of induced bronchoconstriction, and questionnaires on quality of life and knowledge of asthma and its management. In comparison with the control group, the study group showed a trend toward inferior socioeconomic status, education level, and technical abilities (eg, inhaler use). Both groups had similar baseline FEV₁, reversibility of airflow obstruction, methacholine-induced changes in expiratory flows, and perception of bronchoconstriction. Diurnal variation in PEFR was slightly increased in the study group. Absenteeism from work or school was higher in the study group but quality of life score was similar to controls. Patients with frequent ED visits showed significantly lesser knowledge of asthma control criteria, as well as an overall trend toward reduced asthma management knowledge and skills. In conclusion, in addition to the previously reported undertreatment of asthma, other factors such as insufficient asthma management knowledge and skills may contribute to frequent ED visits for asthma.     

The multi‐ethnic global lung initiative 2012 and Third National Health and Nutrition Examination Survey reference values do not reflect spirometric measurements in Black boys and men from Tanzania

The interpretation of spirometric results of Black Africans according to reference standards based on data from outside their native environment may lead to the wrong conclusions. This article aims to characterize the ventilatory capacity of boys and men from Tanzania according to forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), peak expiratory flow (PEF) and FEV₁/FVC based on the collected anthropological material and to compare them to NHANES III, Third National Health and Nutrition Examination Survey (NHANES III) African American predicted values and GLI2012 equations. The analysis included spirometric measurements of n = 295 participants from Tanzania. Pearson's correlation analysis and the backward stepwise multiple regression analysis were performed. FEV₁, FVC, PEF and FEV₁/FVC results were compared to the NHANES III African American predicted values as well as to the GLI2012 equations. FEV₁ measurements are lower than the reference values according to NHANES III and GLI2012 equations by 22·1% and 25·8%. FVC results fell short of the NHANES III predicted by 29·5% and of GLI2012 by 32·5%. The average %FEV₁/FVC scores for the boys and men exceeded the recommended GLI2012 predicted by 10·5–15·2%. All the spirometric measurements included in the analysis were statistically significantly correlated with age, body height, sitting height, trunk length and body weight. The application of prediction formulae developed for non‐African populations overestimates the values for Black Africans. The results of spirometric measurements are ecosensitive and dependent on various external (environmental) factors.     

Pulmonary Functions in Patients With Chronic Neck Pain: A Case-Control Study

ObjectiveThe purpose of the study was to investigate pulmonary functions of patients with chronic neck pain and compare them with those of asymptomatic controls.MethodsThis case-control study was conducted with 25 patients with chronic neck pain (age, 26.84 ± 7.89 years) and 27 age-matched asymptomatic controls (age, 25.96 ± 7.13 years). Pulmonary function tests were performed using spirometry (Quark PFT, COSMED, Rome, Italy). Forced vital capacity (FVC), forced expiratory volume in the first second (FEV₁), forced expiratory flow at 25% to 75% vital capacity, peak expiratory flow, maximum voluntary ventilation, and the FEV₁/FVC ratio were measured and are expressed as (%) predicted value for patients with chronic neck pain and asymptomatic controls.ResultsThe chronic neck pain group had lower FEV₁ (P = .015), FVC (P = .029), forced expiratory flow at 25% to 75% vital capacity (P = .040), and maximum voluntary ventilation (P = .042) compared with asymptomatic controls; however, FEV₁/FVC (P = .470) and peak expiratory flow (P = .183) were similar in both groups.ConclusionThese results demonstrated that dynamic lung volumes were lower in patients with chronic neck pain compared with asymptomatic controls.     

Clinical evaluation of tulobuterol aerosol in childhood asthma

An open clinical trial was performed to assess the efficacy and safety of 400 micrograms tulobuterol aerosol given four times daily in childhood bronchial asthma. A total of 54 children were enrolled with bronchial asthma shown to be reversible by an increase of forced expiratory volume in 1 s (FEV1) of more than 15% following 200 micrograms of salbutamol. Tulobuterol was administered for 3 weeks and regular use of salbutamol was continued for 12 patients during the 7-day lead-in period and six patients took theophylline throughout the study; other drugs were discontinued. The mean FEV1, mean adjusted FEV1, mean peak expiratory flow rate (PEFR) and mean forced vital capacity (FVC) were significantly increased (P less than 0.001) following treatment. Mean FEV1 increases ranged from 9.2% to 14.0%, with 24.5-43.4% of patients showing clinically significant increases of at least 15%. Globally, there was improvement in 46 patients (85%). Headache and nervous system complaints were the most common side-effects. Although this was an uncontrolled study, the indications are that tulobuterol aerosol is effective and safe for use in children with asthma.     

A Randomized,Multicenter, Double-blind,Phase III Study to Evaluate the Efficacy on Allergic Rhinitis and Safety of a Combination Therapy of Montelukast and Levocetirizine in Patients With Asthma and Allergic Rhinitis

Purpose

The aim of this study was to evaluate the efficacy and safety of a fixed-dose combination of montelukast and levocetirizine in patients with perennial allergic rhinitis with mild to moderate asthma compared with the efficacy and safety of montelukast alone.

Effect of Different Positions on FVC and FEV1 Measurements of Asthmatic Patients

[Purpose] The purpose of our study was to investigate the effect of different positions on pulmonary function test (PFT) values such as forced vital capacity (FVC) and forced expiratory volume in one second (FEV₁) of asthmatic patients .[Subjects and Methods] Thirty subjects with severe asthma aged between 20–39 years were enrolled after they had signed a written consent. Subjects were selected using the inclusion criteria, and PFT were randomly administered. Spirometer measurements (FVC, FEV₁) were taken in the supine, side lying on right, side lying on left, sitting and standing positions. Each measurement was taken three times, and the average values were analyzed. [Results] One- way analysis of variance (ANOVA) and Tukey’s Test (post hoc) for pair- wise comparison indicated that there was a significant difference in the FEV₁ values of the asthmatic patients however a significant difference was obtained between standing and supine positions. There was also a significant difference in the FVC values between the standing and supine lying position in the pair -wise comparison. [Conclusion] This study showed standing is the best position for measuring FEV₁ and FVC of asthmatic subjects. The more upright the position, the higher the FEV₁ and FVC will be.Key words: Pulmonary function test, Standing position, Spirometry     

小儿哮喘患儿经普米克令舒联合孟鲁司特治疗前后肺功能及免疫学细胞因子水平变化研究

目的 分析小儿哮喘患儿经普米克令舒联合孟鲁司特治疗前后肺功能及免疫学细胞因子水平变化.方法 选取2018年3月至2019年3月本院儿科收治的哮喘患儿86例,中途退出4例,最终纳入82例.按照治疗方法将其分为联合组和单一组,各组41例.单一组在常规治疗基础上增加孟鲁司特钠咀嚼片,联合组在单一组基础上增加普米克令舒.比较治...     

Salbutamol treatment of acute severe asthma in the ED: MDI versus hand-held nebulizer

The objectives of this study were to compare the efficacy of salbutamol delivered by either metered-dose inhaler plus spacer (MDI-spacer) or by wet nebulization (NEB), and to determine the relationships between physiologic responses and plasma salbutamol concentrations. Asthmatic patients presenting to the emergency department (ED) with acute severe asthma (forced expiratory volume in the first second [FEV₁] less than 50% of predicted) were enrolled in a randomized, double-blind, parallel-group study. The MDI-spacer group received salbutamol, delivered via MDI into a spacer device, in four puffs actuated in rapid succession at 10-minute intervals (2.4 mg/h). The NEB group was treated with nebulized salbutamol, 1.5 mg, via nebulizer at 15-minute intervals (6 mg/h). Doses were calculated on the basis of the percentage of total dose that reaches the lower airway with both methods. The protocol involved 3 hours of this treatment. Mean peak expiratory flow rate (PEFR) and FEV₁ improved significantly over baseline values for both groups (P = .01). However, there were no significant differences between both groups for PEFR and FEV₁ at any point studied. The examination of the relationships between cumulative dose of salbutamol and change in FEV₁ showed a significant linear relationship (P = .01) for both methods (MDI r = .97; NEB r = .97). The regression equations showed that for every 1 mg of salbutamol by MDI-spacer, 2.5 mg are needed from nebulization to have equal therapeutic response. At the end of treatment, the salbutamol plasma levels were 10.1 ± 1.6 ng/ml for the MDI-spacer group and 14.4 ± 2.3 ng/ml for the NEB group (P = .0003). Both groups showed a nonsignificant heart rate decrease. A significant group-by-time interaction means that differences between groups increased with time (P = .04). Additionally, the NEB group presented a higher incidence of tremor (P = .03) and anxiety (P = .04), reflecting larger systemic absorption of salbutamol. These data indicate that when doses used are calculated on the basis of the percentage of total drug that reaches the lower airway, there was equivalent bronchodilatation after salbutamol administered by either MDI-spacer or nebulization in patients with acute severe asthma. However, nebulizer therapy produced greater side effects related to the increase in salbutamol absorption and higher plasma level.     

Potential impacts of Acu-TENS in the treatment of adolescents with moderate to severe bronchial asthma: A randomized clinical study

ObjectiveThe purpose of this study was to evaluate the efficacy of transcutaneous electrical nerve stimulation over the acupuncture points (Acu-TENS) on total serum immunoglobulin E (IgE_total), pulmonary function, and quality of life in adolescents with asthma.MethodsIn a double-blind randomized clinical trial, 32 adolescents (age; 12–16 years) with asthma participated and were assigned randomly to receive either the breathing retraining program (control group) or the breathing retraining program plus Acu-TENS application (Acu-TENS group). Acu-TENS was applied for 40 min’ day-after-day session for two successive months, with no side-effects reported. Serum IgE_total, pulmonary function [forced vital capacity (FVC), forced expiratory volume at one second (FEV₁), and FEV₁/FVC], and quality of life were evaluated pre- and post-treatment.ResultsSerum IgE_total (P = 0.028, η_p² = 0.15), Pulmonary function [FVC (P = 0.043, η_p² = 0.13), FEV₁ (P = .046, η_p² = 0.12)], and quality of life (P < .001, η_p² = 0.17) increased significantly in the Acu-TENS group when compared to the control group.ConclusionThis study demonstrates that the Acu-TENS is an impending asthma treatment that may be used to reinforce the immune system response, ameliorate lung function, and increase the quality of life in adolescents with asthma.     

Effects of inhaled budesonide on insulin sensitivity in nondiabetic patients with asthma and chronic obstructive pulmonary disease

In the study reported here, investigators explored the following: (1) the effects of inhaled corticosteroid (ICS) therapy on insulin sensitivity (IS) (the Homeostatic Model Assessment-Insulin Resistance [HOMA-IR] Index, which has never been used before in nondiabetic patients with asthma and chronic obstructive pulmonary disease [COPD], was used in this investigation); and (2) differences and similarities between asthma and COPD groups. A total of 12 patients with asthma and 6 with COPD who were not previously treated with oral corticosteroids or ICSs were treated with budesonide, 400 μg twice daily for 8 wk, via dry powder inhaler through the Aerolizer. Pretreatment and posttreatment values were recorded for forced expiratory volume in 1 second (FEV₁), forced vital capacity (FVC), FEV₁/FVC, C-reactive protein (CRP), blood glucose, serum insulin levels, area under the curve (AUC) for glucose and insulin in an oral glucose tolerance test (OGTT), and HOMA-IR Index. The trapezoid technique, the formula for HOMA-IR, and Wilkinson, Mann-Whitney U, and t tests were used. In the group of patients with asthma, posttreatment values for the HOMA-IR Index, glucose, and insulin at all time points during OGTT and AUC for glucose and AUC for insulin were not statistically different compared with pretreatment values. In patients with COPD who had been given ICS therapy, however, the second hour glucose level during OGTT increased significantly compared with pretreatment values (P=.46). Pretreatment and posttreatment second hour insulin values and posttreatment AUC for glucose were significantly higher in the COPD group than in the asthma group (P=.047,P=.044, andP=.031, respectively). A moderate positive correlation was noted between the percentage of difference in FEV₁ and the change in HOMA-IR (pretreatment mean value of HOMA-IR±standard deviation [SD], 2.7±2.6) in asthmatic patients as the result of therapy (r=0.50,P=.138). Investigators concluded the following: (1) Differences in pathogenesis between asthma and COPD seem to offer the most plausible explanation for differences in carbohydrate metabolism achieved through ICS therapy; (2) the effect of an ICS on IS is associated not only with dose, treatment period, age, and body mass index (BMI) but also with the severity of initial mucosal inflammation; and (3) as a result of improvements in respiratory function noted after treatment had been given, IS was increased in asthmatic patients.