Yuwen Luo1, Luqian Zhou2, Yun Li1, Songwen Guo1, Xiuxia Li1, Jingjing Zheng1, Zhe Zhu1, Yitai Chen1, Yuxia Huang1, Rui Chen3, Xin Chen4. 1. Department of Respiratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China. 2. State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, Guangzhou Medical University, Guangzhou 510120, China. 3. Department of Respiratory Diseases, SUN Yat-sen Memorial Hospital, SUN Yat-sen University, Guangzhou 510120, China. chen_xin1020@hotmail.com gzchenrui@163.com. 4. Department of Respiratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China. chen_xin1020@hotmail.com gzchenrui@163.com.
Abstract
BACKGROUND: Despite the high prevalence of weight loss in subjects with COPD, the 2011 COPD management guidelines do not include an index measuring nutritional status. Fat-free mass index (FFMI) can accurately determine the nutritional status of subjects and may be closely correlated with COPD severity. We aimed to determine the nutritional status evaluated by FFMI according to the 2011 Global Initiative for Chronic Obstructive Lung Disease (GOLD) levels in stable subjects with COPD and the association between nutritional status and respiratory symptoms, exercise capacity, and respiratory muscle function. METHODS: We included 235 stable subjects with COPD in this cross-sectional study. All of the subjects were divided into the 2011 GOLD Groups A, B, C, and D. FFMI (measured by bioelectrical impedance), spirometry (FEV1, percent-of-predicted FEV1, and FEV1/FVC), respiratory muscle function (peak inspiratory and peak expiratory pressures), exercise capacity (6-min walk distance), and dyspnea severity (Modified Medical Research Council dyspnea scale) were measured and compared between the GOLD groups. RESULTS: Malnutrition was identified in 48.5% of subjects and most prevalent in Group D (Group A: 41%, Group B: 41%, Group C: 31%, and Group D: 62%). FFMI was significantly lower in Group D (P < .001), with both sexes considered malnourished. Low FFMI significantly correlated with frequent exacerbation, older age, decreased pulmonary function, 6-min walk distance, peak inspiratory pressure, and worsened dyspnea. FFMI was significantly lower in the emphysema-dominant phenotype and mixed phenotype compared with the normal phenotype and airway-dominant phenotype. A stepwise multiple linear regression analysis identified peak inspiratory pressures and older age as independent predictors of FFMI. CONCLUSIONS: Malnutrition is highly prevalent in all COPD groups, particularly in Group D subjects, who warrant special attention for nutritional intervention and pulmonary rehabilitation. FFMI significantly correlated with exercise capacity, dyspnea, respiratory muscle function, and pulmonary function and may be a useful predictor of COPD severity.
BACKGROUND: Despite the high prevalence of weight loss in subjects with COPD, the 2011 COPD management guidelines do not include an index measuring nutritional status. Fat-free mass index (FFMI) can accurately determine the nutritional status of subjects and may be closely correlated with COPD severity. We aimed to determine the nutritional status evaluated by FFMI according to the 2011 Global Initiative for Chronic Obstructive Lung Disease (GOLD) levels in stable subjects with COPD and the association between nutritional status and respiratory symptoms, exercise capacity, and respiratory muscle function. METHODS: We included 235 stable subjects with COPD in this cross-sectional study. All of the subjects were divided into the 2011 GOLD Groups A, B, C, and D. FFMI (measured by bioelectrical impedance), spirometry (FEV1, percent-of-predicted FEV1, and FEV1/FVC), respiratory muscle function (peak inspiratory and peak expiratory pressures), exercise capacity (6-min walk distance), and dyspnea severity (Modified Medical Research Council dyspnea scale) were measured and compared between the GOLD groups. RESULTS: Malnutrition was identified in 48.5% of subjects and most prevalent in Group D (Group A: 41%, Group B: 41%, Group C: 31%, and Group D: 62%). FFMI was significantly lower in Group D (P < .001), with both sexes considered malnourished. Low FFMI significantly correlated with frequent exacerbation, older age, decreased pulmonary function, 6-min walk distance, peak inspiratory pressure, and worsened dyspnea. FFMI was significantly lower in the emphysema-dominant phenotype and mixed phenotype compared with the normal phenotype and airway-dominant phenotype. A stepwise multiple linear regression analysis identified peak inspiratory pressures and older age as independent predictors of FFMI. CONCLUSIONS: Malnutrition is highly prevalent in all COPD groups, particularly in Group D subjects, who warrant special attention for nutritional intervention and pulmonary rehabilitation. FFMI significantly correlated with exercise capacity, dyspnea, respiratory muscle function, and pulmonary function and may be a useful predictor of COPD severity.
Authors: A Travassos; A Rodrigues; K C Furlanetto; L Donária; G W Bisca; A G Nellessen; F Pitta; N A Hernandes Journal: Eur J Clin Nutr Date: 2017-07-19 Impact factor: 4.016
Authors: F de Blasio; M G Santaniello; F de Blasio; G Mazzarella; A Bianco; L Lionetti; F M E Franssen; L Scalfi Journal: Eur J Clin Nutr Date: 2017-09-13 Impact factor: 4.016
Authors: Lies Ter Beek; Hester van der Vaart; Johan B Wempe; Aliaksandra O Dzialendzik; Jan Ln Roodenburg; Cees P van der Schans; Heather H Keller; Harriët Jager-Wittenaar Journal: Int J Chron Obstruct Pulmon Dis Date: 2018-04-23