scholarly journals Effect of malnutrition and body composition on the quality of life of COPD patients

Author(s):  
M. Fekete ◽  
V. Fazekas-Pongor ◽  
P. Balazs ◽  
S. Tarantini ◽  
G. Szollosi ◽  
...  

AbstractBackgroundPathological alterations in nutritional status may develop in Chronic Obstructive Pulmonary Disease (COPD) patients through production of inflammatory cytokines and inadequate diet.ObjectiveThe aim of our study was to determine the correlation between nutritional status and quality of life of COPD patients.MethodsWe evaluated the nutritional status of COPD patients of Hungarian National Koranyi Institute for Pulmonology using the Malnutrition Universal Screening Tool (MUST) and bioelectrical impedance analysis (BIA) between January 1 and June 1, 2019. Lung function, physical fitness, and respiratory muscle strength were included in the assessment.ResultsFifty patients (mean age was 66.3 ± 9.6 years) participated in our study. Mean body mass index (BMI) was 26.2 ± 6.1 kg/m2 and mean fat-free mass index (FFMI) was 16.8 ± 2.4 kg/m2. Overweight patients had better lung function values (FEV1ref%: 46.3 ± 15.2) than normal (FEV1ref%: 45.1 ± 20.9) and underweight patients (FEV1ref%: 43.8 ± 16.0). The Modified Medical Research Council Dyspnea Scale (mMRC) was significantly associated with various parameters; strongest correlation was found with FFMI (r = −0.537, P < 0.001), skeletal muscle mass index (SMMI) (r = −0.530, P < 0.001), and 6-minute walking distance (6MWD) (r = −0.481, P < 0.001).ConclusionsOur results indicate that malnourished COPD patients may have reduced lung function and lower quality of life compared to normal weight patients. Thus, our findings suggest that nutritional therapy be included in the treatment of COPD patients combined with nutritional risk screening and BIA during the follow-up.

2021 ◽  
Vol 162 (5) ◽  
pp. 185-191
Author(s):  
Mónika Fekete ◽  
Vince Fazekas-Pongor ◽  
Gergő Szőllősi ◽  
János Tamás Varga

Összefoglaló. Bevezetés: Krónikus obstruktív tüdőbetegségben (COPD) az obesitas mellett a csökkent fizikai aktivitás nagymértékben fokozza a metabolikus szindróma kialakulásának valószínűségét. Célkitűzés: Kutatásunk célja volt felmérni a metabolikus szindróma prevalenciáját COPD-ben, valamint azt, hogy milyen mértékben függ össze az életkorral, a nemmel, a társbetegségekkel, a tüdőfunkció károsodásának mértékével, a tápláltsági állapottal, a fizikai terhelhetőséggel és az életminőséggel. Módszer: Keresztmetszeti vizsgálatot végeztünk az Országos Korányi Pulmonológiai Intézet Légzésrehabilitációs Osztályán fekvő betegek körében 2019. július 1. és december 31. között. A véletlenszerűen kiválasztott 300, 40 év feletti betegnek ismertük az antropometriai, légzésfunkciós vizsgálati eredményét és laboratóriumi paramétereit. Adatokat gyűjtöttünk a dohányzási szokásokról, az előző évi exacerbatiók számáról és a kortikoszteroidok használatáról is. Az életminőség mérésére a betegségspecifikus Szent György-féle Légzési Kérdőív magyar nyelvre validált változatát használtuk. A metabolikus szindrómát a Nemzetközi Diabetes Szövetség kritériumai alapján határoztuk meg. Eredmények: A metabolikus szindróma a betegek 72%-ánál fordult elő, férfi: 65,9% nő: 77,2% (p = 0,031). A metabolikus szindrómás betegek esetében rövidebb 6 perces sétatávolságot mértünk ([m] 250 [150–330] vs. 295 [162–360]; p = 0,384), és szignifikánsan több volt az előző évi exacerbatiók száma (3 [0–6] vs. 1 [1–2]; p<0,001) a nem metabolikus szindrómás betegekhez képest. A BMI-re történő stratifikáció után a metabolikus szindróma jelenléte nagyobb volt BMI≥25 kg/m2 esetén. A hasi elhízás, a magas vérnyomás, a hyperlipidaemia és a hyperglykaemia szignifikánsan gyakoribb volt BMI≥25 kg/m2 esetén (p<0,001). Következtetés: Eredményeink azt sugallják, hogy a metabolikus szindrómás betegekben megnő az együttes morbiditási index, különösen azok körében, akik túlsúlyosak vagy elhízottak. Ezért a COPD-s betegekben nagyon fontos időben felismerni és megfelelően kezelni a metabolikus szindrómát. Orv Hetil. 2021; 162(5): 185–191. Summary. Introduction: Both obesity and the lack of physical activity among chronic obstructive pulmonary disease (COPD) patients increase the risk of developing metabolic syndrome. Objective: The goal of our study was to assess the prevalence of metabolic syndrome among COPD patients and to examine its correlation with age, gender, comorbidities, lung function values, nutritional status, exercise capacity, and quality of life. Method: A cross-sectional study was performed at the Department of Pulmonary Rehabilitation of the Hungarian National Korányi Institute for Pulmonology between July 1st and December 31st, 2019. A total of 300 patients aged over 40 were selected at random. Anthropometric data were collected along with lung function values, laboratory parameters, smoking status, the number of exacerbations in the previous year, and the use of corticosteroids. Quality of life was measured by the validated Hungarian, COPD-specific Saint George Respiratory Questionnaire. Metabolic syndrome was defined according to the International Diabetes Federation criteria. Results: Metabolic syndrome affected 72% of COPD patients (male: 65.9%, female 77.2%; p = 0.031). In patients with metabolic syndrome, shorter 6-minute walking distance was measured ([m] 250 [150–330] vs. 295 [162–360]; p = 0.384) and the number of exacerbations in the previous year was significantly higher (3 [0–6] vs. 1 [1–2]; p<0.001) compared to patients with no metabolic syndrome. After stratification for BMI, metabolic syndrome was more frequent in the case of BMI≥25 kg/m2. Central adiposity, hypertension, hyperlipidemia, and hyperglycemia were also significantly more frequent among patients with BMI≥25 kg/m2 (p<0.001). Conclusion: Our results suggest that the co-morbidity index increases in patients with metabolic syndrome, especially in overweight or obese patients. Therefore, early detection and appropriate treatment of metabolic syndrome in patients with COPD is very important. Orv Hetil. 2021; 162(5): 185–191.


2019 ◽  
Vol 39 (2) ◽  
pp. 79-87
Author(s):  
Sasongko Adhi Nugroho ◽  
Teguh Rahayu Sartono ◽  
Susanthy Djajalaksana ◽  
Harun Al Rasyid

Background: Muscle wasting is one of the extrapulmonary manifestation which influence quality of life in Chronic Obstructive Pulmonary Disease (COPD) patients. It caused by imbalance of protein metabolism in skeletal muscle. This study aimed to evaluate the effect of Ophiocephalus striatus extract on neutrophil count, soluble urokinase-type plasminogen activator (suPAR) level, diffusion capacity of lung for carbon monoxide (DLCO) and quality of life in stable COPD patients with muscle wasting. Methods: Clinical pre and post quasi experimental study was conducted to 32 stable muscle-wasted COPD patients from Pulmonary Outpatient Clinic Saiful Anwar Hospital Malang, determined by The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2016, Bioelectrical impedance analysis (BIA) dengan fat-free mass (FFM)


2019 ◽  
Vol 38 (4) ◽  
pp. 203-9
Author(s):  
Romaito Nasution ◽  
Irvan Medison ◽  
Deddy Herman ◽  
Masrul Basyar

Background: Post pulmonary tuberculosis (TB) patients could experience pulmonary function declines which affected their quality of life. Obstrucitve abnormalities were found the most after complete TB treatment and the therapeutic guidelines focused in bronchodilators. The use of bronchodilators could improve lung function and quality of life in post TB patients with obstructive abnormalities. Tiotropium is a bronchodilator that has been shown to be effective in chronic obstructive pulmonary disease (COPD) patients, while its use in post TB patients has not been widely studied. Methods: This study design was a clinical trial with pre and post test design in post TB patients in Dr.M.Djamil Padang General Hospital and Lubuk Alung Pulmonary Hospital conducted from November 2016 to June 2017. Results: Of 30 post TB patients, the mean age was 62.77±10.99 years, most were male (63.33%), non-smokers and former smokers (50% each), had interval from complete anti TB drugs to study ≥6 months (53.3%), and moderate level of obstruction (80%). Pulmonary function prior to tiotropium was generally in moderate obstruction (FEV1 68,85±15,77). The mean quality of life prior to tiotropium was 18.27±10.81. There was no improvement in pulmonary function of post TB patients after administration of tiotropium, P=0.920, however, there was an improvement in the quality of life, P=0.009. No adverse events were found in this study. Conclusions: Administration of 2 months tiotropium in post TB patients had no effects on the improvements of lung function but improved the quality of life. More studies were needed using more patients and longer duration of administration. (J Respir Indo. 2018; 38: 203-9)


Author(s):  
Chaicharn Pothirat ◽  
Warawut Chaiwong ◽  
Chalerm Liwsrisakun ◽  
Chaiwat Bumroongkit ◽  
Athavudh Deesomchok ◽  
...  

The impact of outdoor air pollution on the quality of life (QoL) of chronic obstructive pulmonary disease (COPD) patients, as measured by the COPD assessment test (CAT) questionnaire, is limited. The aim of this study was to determine the impact of a short-term increase in outdoor particulate matter in which the particles are less than 10 microns in diameter (PM10) during a seasonal smog period on QoL, symptoms, and lung function in COPD patients. This prospective observational study was conducted at Chiang Dao Hospital, Chiang Mai, Thailand between March and August 2016. Measurement of QoL, severity of dyspnea, forced vital capacity (FVC), and forced expiratory volume in the first second (FEV1) were performed at both high and low PM10 periods. Fifty-nine patients met the inclusion criteria for enrollment into the study, with the mean age being 71.5 ± 8.0 years. Total CAT score, but not mMRC score, was statistically higher during the high PM10 period. The two lung function parameters, FVC and FEV1, were significantly lower at the high PM10 compared to the low PM10 period. We concluded that exposure to PM10 during the seasonal smog period resulted in short-term negative impact on the quality of life and lung function in COPD patients.


2011 ◽  
Vol 139 (5-6) ◽  
pp. 322-327 ◽  
Author(s):  
Ivan Cekerevac ◽  
Zorica Lazic

Introduction. Nutritional abnormalities have one of the most important systematic effects on chronic obstructive pulmonary disease (COPD). A relationship between COPD and obesity has been observed and recognized. In COPD patients, beside changes in the total body weight, changes in body composition are also possible with the loss of fat-free mass (FFM). Objective. This study was undertaken to evaluate the impact of obesity and the change of body composition on the pulmonary function, dyspnoea level and the quality of life in COPD patients. Methods. Seventy-nine patients in the stable state of COPD were evaluated. Pulmonary function and arterial blood gas analysis were assessed. Nutritional status was analyzed according to Body Mass Index (BMI). Body composition was evaluated by using anthropometric measurement by fat free mass index (FFMI). Quality of life was assessed using the St. George Respiratory Questionnaire (SGRQ). The Visual Analogue Scale (VAS) was used to evaluate dyspnoea. Results. The highest prevalence of obesity (50.0%) was found in patients with mild COPD, while the lowest prevalence was detected in very severe COPD patients (10.0%). The loss of FFM occurred in 22.2% patients with normal body weight and in 9.0% of overweight COPD patients. The quality of life was lower in obese patients compared to other COPD patients. A higher dyspnoea level was also present in obese patients. The lowest airflow obstruction was in obese patients (p=0.023). We found a significant positive correlation between forced expiratory volume in the first second (FEV1%) and BMI (r=0.326, p=0.003), FEV1% and FFMI (r=0.321, p=0.004). Conclusion. The highest prevalence of obesity was in patients with mild COPD. Obese patients with COPD had the lowest level of airflow obstruction, higher dyspnoea level and lower quality of life in comparison to other COPD patients.


2021 ◽  
Vol 162 (1) ◽  
pp. 23-30
Author(s):  
Mónika Fekete ◽  
Gergő Szőllősi ◽  
Anna Noémi Németh ◽  
János Tamás Varga

Összefoglaló. Bevezetés: Civilizált világunk, miközben látszólag túltáplált, ómega-3-hiányban szenved. A hosszú szénláncú, többszörösen telítetlen zsírsavak számos anyagcsere-megbetegedés (például elhízás, 2-es típusú diabetes mellitus, szív- és érrendszeri megbetegedések) kialakulásában játszhatnak szerepet. A halolajban lévő zsírsavak erősítik az immunrendszert, csökkentik a koleszterin- és trigliceridszintet, csökkentik a gyulladást. Célkitűzés: Vizsgálatunk célja a többszörösen telítetlen zsírsavak bevitelének monitorozása, valamint a tüdőfunkcióval és az életminőséggel való kapcsolatuk értékelése krónikus obstruktív tüdőbetegségben (COPD). Módszer: Kérdőívünket az Országos Korányi Pulmonológiai Intézet Légzésrehabilitációs Osztályán, 2019. március 1. és 2020. március 1. között 40 év feletti COPD-s betegek körében vettük fel. Az életminőség mérésére a betegségspecifikus Szent György Légzési Kérdőívet alkalmaztuk, a légzésfunkciós és antropometriai adatokat az egészségügyi elektronikus nyilvántartási rendszerből nyertük ki. Eredmények: A betegek medián életkora 66 (IQR 60–73) év volt, a nemek közötti megoszlást tekintve 47,5% férfi és 52,5% nő. A medián BMI 26,0 (IQR 21,7–30,6) kg/m2, a FEV1 (ref%) 48,0 (IQR 38,1–55,3) volt. Az ómega-3 zsírsavakat a betegek 4,7%-a (n = 19) szedi rendszeresen, elsősorban kezelőorvosa javaslatára, a javasolt napi dózisban (0,25–0,50 g/nap). Esetükben jobb életminőséget tapasztaltunk (65,8 [52,4–79,7] vs. 72,2 [56,2–88,6]; p = 0,044), kevesebb társbetegséggel rendelkeztek (hypertonia: 10 [52,6%] vs. 275 [72,1%]; p = 0,066), kevesebb gyógyszert használtak (gyors hatású béta-2-agonista: 5 [25,3%] vs. 197 [51,7%]; p = 0,031), alacsonyabb volt a fellángolások száma (1 [1–3] vs. 2 [1–4]; p = 0,029), és nagyobb volt a 6 perces sétatávolság (300 [177–387] vs. 251 [150–345]; p = 0,121). Következtetés: Eredményeink arra utalnak, hogy a többszörösen telítetlen zsírsavak bevitele összefüggésben lehet az életminőséggel COPD-s betegekben. Vizsgálatunk szerint a betegek ómega-3-bevitele nem kielégítő – eredményeink alapján szeretnénk felhívni a figyelmet e zsírok fogyasztásának fontosságára. Orv Hetil. 2021; 162(1): 23–30. Summary. Introduction: Our civilized world, while seems to be overweight, suffers from omega-3 deficiency. Long-chain polyunsaturated fatty acids can play a role in the development of many metabolic diseases (e.g., obesity, type 2 diabetes mellitus, cardiovascular disease). Fatty acids in fish oil strengthen the immune system, reduce cholesterol and triglyceride levels, have been proven to be beneficial, reduce inflammation. Objective: The aim of our study was to monitor the intake of polyunsaturated fatty acids and to evaluate their relationship with lung function and quality of life in patients with chronic obstructive pulmonary disease (COPD). Method: Our questionnaire was completed at the Department of Pulmonary Rehabilitation of the National Koranyi Institute for Pulmonology between March 1, 2019 and March 1, 2020 among COPD patients over 40 years of age. We used the disease-specific St. George’s Respiratory Questionnaire to measure the quality of life; the respiratory function and anthropometric data were extracted from the electronic health record system. Results: The median age of the patients was 66 (IQR 60–73) years, with a gender division of 47.5% male and 52.5% female. The median BMI was 26.0 (IQR 21.7–30.6) kg/m2, and the median FEV1 (%pred) was 48.0 (IQR 38.1–55.3). In the form of a dietary supplement, 4.7% (n = 19) of patients take omega-3 fatty acids regularly, mainly on the recommendation of their doctor, at the recommended daily dose (0.25–0.50 g/day). Among them, we detected a better quality of life (65.8 [52.4–79.7] vs. 72.2 [56.2–88.6]; p = 0.044), had fewer comorbidities (hypertension: 10 [52.6%] vs. 275 [72.1%]; p = 0.066), consumed fewer drugs (short-acting bronchodilators: 5 [25.3%] vs. 197 [51.7%]; p = 0.031), had fewer exacerbations (1 [1–3] vs. 2 [1–4]; p = 0.029), and higher six-minute walking distance (300 [177–387] vs. 251 [150–345]; p = 0.121). Conclusion: Our results suggest that the intake of polyunsaturated fatty acids may be related to the quality of life in COPD patients. According to our study, the intake of omega-3 in patients is unsatisfactory, and based on our results, we would like to draw attention to the importance of consuming these fats. Orv Hetil. 2021; 162(1): 23–30.


2019 ◽  
Vol 70 (11) ◽  
pp. 3935-3941
Author(s):  
Roxana Maria Nemes ◽  
Florentina Ligia Furtunescu ◽  
Ioan Sorin Tudorache ◽  
Tudor Harsovescu ◽  
Alexandra Floriana Nemes ◽  
...  

We analyze the lung function using advanced measurement (body plethysmography) and standard measurement (spirometry) in stable COPD (Chronic Obstructive Pulmonary Disease) patients. Subjects and methods: 211 patients with stable COPD (88.6% males) age 61�5 years (mean � standard deviation), exsmokers 78.7%, underwent to: body pletysmography , spirometry, electrocardiography. Parameters obtained: residual volume (RV), forced expiratory volume in 1 second (FEV1), were correlated with different parameters and also for prediction of quality of life in COPD patients. In assessing the quality of life we used the St. George�s Respiratory Questionnaire (SGRQ). According to BMI (body mass index) we classify patients in four groups: 1. underweight ([ 20, n = 34), 2. normal weight (20-24, n = 79), 3. overweight (25-29.9, n = 58), 4. obese ( ]30, n = 40), n = number of patients.


2019 ◽  
Vol 70 (11) ◽  
pp. 3935-3941
Author(s):  
Roxana Maria Nemes ◽  
Florentina Ligia Furtunescu ◽  
Ioan Sorin Tudorache ◽  
Tudor Harsovescu ◽  
Alexandra Floriana Nemes ◽  
...  

We analyze the lung function using advanced measurement (body plethysmography) and standard measurement (spirometry) in stable COPD (Chronic Obstructive Pulmonary Disease) patients. Subjects and methods: 211 patients with stable COPD (88.6% males) age 61�5 years (mean � standard deviation), exsmokers 78.7%, underwent to: body pletysmography , spirometry, electrocardiography. Parameters obtained: residual volume (RV), forced expiratory volume in 1 second (FEV1), were correlated with different parameters and also for prediction of quality of life in COPD patients. In assessing the quality of life we used the St. George�s Respiratory Questionnaire (SGRQ). According to BMI (body mass index) we classify patients in four groups: 1. underweight ([ 20, n = 34), 2. normal weight (20-24, n = 79), 3. overweight (25-29.9, n = 58), 4. obese ( ]30, n = 40), n = number of patients.


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