Nutritional modulation as part of the integrated management of chronic obstructive pulmonary disease

Weight loss is a frequent complication in patients with chronic obstructive pulmonary disease (COPD) and is a determining factor for functional capacity, health status and mortality. Weight loss in COPD is a consequence of an inbalance between increased energy requirements and dietary intake. Both metabolic and mechanical inefficiency may contribute to elevated energy expenditure during physical activity, while systemic inflammation has been associated with hypermetabolism at rest. Disease-specific symptoms and systemic inflammation may impair appetite and dietary intake. Altered intermediary metabolism may cause disproportionate wasting of fat-free mass in some patients. A combination of nutritional support and exercise as an anabolic stimulus appears to be the best approach to obtaining marked functional improvement. Patients responding to this treatment even demonstrated a decreased mortality. The effectiveness of anti-catabolic modulation requires further investigation.

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P.21 Serum leptin levels and dietary intake are modulatedby systemic inflammation in chronic obstructive pulmonary disease

Clinical Nutrition ◽

10.1016/s0261-5614(97)80145-8 ◽

1997 ◽

Vol 16 ◽

pp. 28 ◽

Cited By ~ 1

Author(s):

A.M.W.J. Schols ◽

E.C. Creutzberg ◽

A. Campfield ◽

W.A. Buurman ◽

W.H.M. Saris ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Dietary Intake ◽

Pulmonary Disease ◽

Systemic Inflammation ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Serum Leptin

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Comorbid conditions at chronic obstructive pulmonary disease: the questions under investigation and discussion

Ukrainian Therapeutical Journal ◽

10.30978/utj2021-1-85 ◽

2021 ◽

Author(s):

O. I. Lemko ◽

M. O. Haysak ◽

D. V. Reshetar

Keyword(s):

Oxidative Stress ◽

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Systemic Inflammation ◽

Molecular Mechanisms ◽

Integrated Management ◽

Chronic Obstructive ◽

Comorbid Conditions ◽

Obstructive Pulmonary Disease ◽

Pathogenetic Mechanisms

Today, chronic obstructive pulmonary disease is considered as a multifactorial disease with systemic extrapulmonary manifestations and a high level of comorbidity. Differentiation of the polymorbidity and comorbidity concepts for patients with this pathology is very important. The common trigger factors and/or pathogenetic mechanisms lay in the basis of comorbid conditions, and their progression is comparable in time with the underlying disease. This determines the necessity for appropriate integrated management of such patients. The presence of other diseases that are not related to the main pathological process through common causative factors and/or pathogenetic mechanisms should be regarded as concomitant and lying in the basis for polymorbidity. The domestic and foreign scientific literature data on the mechanisms of potential comorbid pathology in this group of patients have been summarized. Information concerning the leading role of oxidative stress and systemic inflammatory process of low intensity in the development of comorbidity in chronic obstructive pulmonary disease is presented. The mechanisms of their influence, relationship, discussion questions and actual data on genetic and molecular mechanisms of development of these pathological processes are highlighted. Special attention is paid to the metabolic processes that develop as a result of oxidative stress and systemic inflammation. In particular, it has been shown that systemic inflammation leads to the development of insulin resistance, diabetes and other metabolic disorders. Data is outlined, supporting rationale for stratification of the metabolic profiles or phenotypes, as well as the pathogenetic significance of endotoxemia. Endothelial dysfunction and associated diseases of the cardiovascular system are also the consequences of oxidative stress and systemic inflammation. The analysis has been performed for the peculiarities of the manifestations of some of them in this group of patients.

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