Nutritional status and muscle mass loss in patients with COPD, association with lung function, symptoms, comorbidities and long-term survival: data from the National Database Study.

IF 0.7 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL
Eva Volakova, Vladimir Koblizek, Michal Svoboda, Karel Hejduk, Marek Plutinsky, Kristian Brat, Martina Kulirova, Jaromir Zatloukal
{"title":"Nutritional status and muscle mass loss in patients with COPD, association with lung function, symptoms, comorbidities and long-term survival: data from the National Database Study.","authors":"Eva Volakova, Vladimir Koblizek, Michal Svoboda, Karel Hejduk, Marek Plutinsky, Kristian Brat, Martina Kulirova, Jaromir Zatloukal","doi":"10.5507/bp.2025.001","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>To assess nutritional status and muscle mass loss in patients with chronic obstructice pulmonary disease (COPD) from the Czech National Database of COPD and to evaluate the association of nutritional parameters with COPD phenotype, lung function, COPD-related symptoms and long-term survival.</p><p><strong>Methods: </strong>A total of 343 patients with known body composition parameters - body mass Index (BMI), fat-free mass index (FFMI) and mid-art muscle circumference (MAMC) - were included in the analysis. Descriptive statistical methods were used to assess differences between groups, and overall survival was assessed using the Kaplan-Meier method after 9 years of follow-up.</p><p><strong>Results: </strong>Nutritional imbalances were common in patients with COPD. Underweight and muscle mass loss were associated with emphysematous and pulmonary cachexia phenotypes, worse lung function, more symptoms and exacerbations, osteoporosis and depression. Overweight and obesity were associated with a chronic bronchitis phenotype and cardiovascular and metabolic comorbidities. Obese patients had higher forced exspiratory volume in 1 second (FEV<sub>1</sub>) and diffusing capacity of the lung for carbon monoxid (DL<sub>CO</sub>), but lower forced exspiratory capacity (FVC). Malnutrition increased the risk of death. Cachexia and underweight reduced median survival from 72.0 to 43.5 (P=0.049) and 39.8 (P=0.010) months, respectively, compared to normal nutrition. Muscle mass loss by MAMC of ≥20% was the strongest predictor of mortality, increasing the risk of death by 5.5-fold compared to patients with normal muscle mass (P<0.001). Patients with overweight and obesity had a 40% (P=0.026) and 30% lower risk of death, respectively, compared to patients with normal nutrition.</p><p><strong>Conclusions: </strong>Patients with COPD often have nutritional imbalances. That is an important determinant of clinical characteristics and outcomes in patients with COPD. Further research is needed to better understand these differences.</p>","PeriodicalId":55363,"journal":{"name":"Biomedical Papers-Olomouc","volume":" ","pages":""},"PeriodicalIF":0.7000,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Biomedical Papers-Olomouc","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5507/bp.2025.001","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0

Abstract

Aim: To assess nutritional status and muscle mass loss in patients with chronic obstructice pulmonary disease (COPD) from the Czech National Database of COPD and to evaluate the association of nutritional parameters with COPD phenotype, lung function, COPD-related symptoms and long-term survival.

Methods: A total of 343 patients with known body composition parameters - body mass Index (BMI), fat-free mass index (FFMI) and mid-art muscle circumference (MAMC) - were included in the analysis. Descriptive statistical methods were used to assess differences between groups, and overall survival was assessed using the Kaplan-Meier method after 9 years of follow-up.

Results: Nutritional imbalances were common in patients with COPD. Underweight and muscle mass loss were associated with emphysematous and pulmonary cachexia phenotypes, worse lung function, more symptoms and exacerbations, osteoporosis and depression. Overweight and obesity were associated with a chronic bronchitis phenotype and cardiovascular and metabolic comorbidities. Obese patients had higher forced exspiratory volume in 1 second (FEV1) and diffusing capacity of the lung for carbon monoxid (DLCO), but lower forced exspiratory capacity (FVC). Malnutrition increased the risk of death. Cachexia and underweight reduced median survival from 72.0 to 43.5 (P=0.049) and 39.8 (P=0.010) months, respectively, compared to normal nutrition. Muscle mass loss by MAMC of ≥20% was the strongest predictor of mortality, increasing the risk of death by 5.5-fold compared to patients with normal muscle mass (P<0.001). Patients with overweight and obesity had a 40% (P=0.026) and 30% lower risk of death, respectively, compared to patients with normal nutrition.

Conclusions: Patients with COPD often have nutritional imbalances. That is an important determinant of clinical characteristics and outcomes in patients with COPD. Further research is needed to better understand these differences.

慢性阻塞性肺病患者的营养状况和肌肉质量损失,与肺功能、症状、合并症和长期生存的关系:来自国家数据库研究的数据
目的:从捷克国家COPD数据库中评估慢性阻塞性肺疾病(COPD)患者的营养状况和肌肉质量损失,并评估营养参数与COPD表型、肺功能、COPD相关症状和长期生存的关系。方法:选取343例已知身体组成参数(身体质量指数(BMI)、无脂质量指数(FFMI)和中围肌(MAMC))的患者进行分析。采用描述性统计方法评估组间差异,随访9年后采用Kaplan-Meier法评估总生存率。结果:慢性阻塞性肺病患者营养失衡较为常见。体重不足和肌肉质量减少与肺气肿和肺恶病质表型、肺功能恶化、更多症状和恶化、骨质疏松和抑郁相关。超重和肥胖与慢性支气管炎表型以及心血管和代谢合并症有关。肥胖患者1秒强迫呼吸量(FEV1)和肺一氧化碳弥散量(DLCO)较高,但强迫呼吸量(FVC)较低。营养不良增加了死亡的危险。与正常营养相比,恶病质和体重不足使中位生存期分别从72.0个月降至43.5个月(P=0.049)和39.8个月(P=0.010)。肌肉质量损失≥20%是死亡率的最强预测因子,与肌肉质量正常的患者相比,死亡风险增加5.5倍(结论:COPD患者通常存在营养失衡)。这是COPD患者临床特征和预后的重要决定因素。需要进一步的研究来更好地理解这些差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Biomedical Papers-Olomouc
Biomedical Papers-Olomouc MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
2.30
自引率
0.00%
发文量
74
审稿时长
6-12 weeks
期刊介绍: Biomedical Papers is a journal of Palacký University Olomouc, Faculty of Medicine and Dentistry, Olomouc, Czech Republic. It includes reviews and original articles reporting on basic and clinical research in medicine. Biomedical Papers is published as one volume per year in four issues.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信