| Assessment of nutritional status of patients with chronic obstructive pulmonary disease. |
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Kwang Joo Park, Chul Min Ahn, Hyung Jung Kim, Joon Chang, Sung Kyu Kim, Won Young Lee |
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Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea. |
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| Abstract |
BACKGROUND
Malnutrition is a common finding in patients with chronic obstructive pulmonary disease, especially in the emphysema group. Although the mechanism of malnutrition is not confined, it is believed to be a relative deficiency caused by hypermetabolism due to increased energy requirements of the respiratory muscles, rather than dietary deficiency. Malnutrition in chronic obstructive pulmonary disease is not a merely coincidental fading. It is known that the nutritional status correlates with physiologic parameters including pulmonary function, muscular power, and exercise performance, and is one of the important and independent prognostic factors of the disease. METHODS: Patients with chronic obstructive pulmonary. disease at Yongdong Severance Hospital from May, 1995 to March, 1996 and age-matched healthy control group were studied. Survey of nutritional intake, anthropometric measurements and biochemical tests were done to assess nutritional status. Relationship between nutritional status and FEV1(forced expiratory volume at one second), which was a significant functional parameter, was assessed. RESULTS:1) The patient group was consisted of 25 males with mean age of 66.1 years and FEV1 of 42+/-14% of predicted values. The control group was consisted of 26 healthy males with normal pulmonary function, whose mean age was 65.0 years. 2) The ratio of calorie intake/calorie requirement per day was 107+/-28% in the patient group, and 94+/-14% in the control group, showing a tendency of more nutritional intake in the patient group(p=0.06). 3) There were significant differences between the patient group and control group in percent ideal body weight(92.8% vs. 101.6%, p=0.024), body mass index(20.0kg/m2 vs. 21.9kg/m2, p=0.015), and handgrip strength(29.0kg vs. 34.3kg, p=0.003). However, there were no significant differences in triceps skinfold thickness, mid-arm muscle circumference, albumin, and total lymphocyte count between two groups. Percentage of underweight population was 40%(10/25) in the patient group, and 15%(4/26) in the control group. 4) The percent ideal body weight, triceps skinfold thickness, and mid-arm muscle circumference had significant correlation with FEV1. CONCLUSION: The patients with chronic obstructive pulmonary disease showed significant depletion in nutritional parameters such as body weight and peripheral muscle strength, while absolute amount of dietary intake was not insufficient. Nutritional parameters were well correlated with FEV1. |
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