Sergi Giuseppe, Coin Alessandra, Marin Sara, Vianello Andrea, Manzan Alessandro, Peruzza Silvia, Inelmen Emine Meral, Busetto Luca, Mulone Silvana, Enzi Giuliano
Department of Medical and Surgical Sciences, Division of Geriatrics, University of Padua, Padua Italy.
Respir Med. 2006 Nov;100(11):1918-24. doi: 10.1016/j.rmed.2006.03.008. Epub 2006 Apr 24.
Our study investigates nutritional status, resting energy expenditure (REE) and physical performance in elderly patients with stable COPD to identify any early conditions of hypermetabolism, malnutrition and sarcopenia.
Eighty-six males (40 stable COPD and 46 healthy subjects) over 65 years old were studied. All subjects underwent spirometry, blood gas analysis and a 6-min walking test (6MWT). Fat-free mass (FFM) and appendicular skeletal muscle mass (ASMM) were measured by dual energy X-ray absorptiometry (DEXA). REE was measured by indirect calorimetry.
COPD patients had a lower FFM both expressed in kilograms and after correction for height squared. The prevalence of sarcopenia was higher for COPD subjects (38% vs 31%). REE, both in absolute values and adjusted for FFM was significantly higher in COPD patients. Hypermetabolism was found in 60% of COPD cases and 13.7% (P<0.01) of healthy subjects. No relationship was found in COPD patients between the measured/predicted REE ratio (REE(m)/REE(p)) and FEV1. In the hypermetabolic COPD subgroup, the REE(m)/REE(p) ratio correlated with 6MWT.
Elderly patients with stable COPD develop an increased REE. This hypermetabolism seems to be independent of the severity of the pulmonary obstruction and to influence the patient's physical performance.
我们的研究调查了稳定期慢性阻塞性肺疾病（COPD）老年患者的营养状况、静息能量消耗（REE）和身体机能，以确定任何早期的高代谢、营养不良和肌肉减少症情况。
对86名65岁以上的男性进行了研究（40名稳定期COPD患者和46名健康受试者）。所有受试者均接受了肺功能测定、血气分析和6分钟步行试验（6MWT）。通过双能X线吸收法（DEXA）测量无脂肪质量（FFM）和四肢骨骼肌质量（ASMM）。通过间接测热法测量REE。
COPD患者的FFM无论是以千克表示还是校正身高平方后均较低。COPD受试者肌肉减少症的患病率更高（38%对31%）。COPD患者的REE绝对值以及校正FFM后的REE均显著更高。60%的COPD病例和13.7%的健康受试者存在高代谢。在COPD患者中，未发现测量的/预测的REE比值（REE(m)/REE(p)）与第一秒用力呼气容积（FEV1）之间存在关联。在高代谢的COPD亚组中，REE(m)/REE(p)比值与6MWT相关。
稳定期COPD老年患者的REE增加。这种高代谢似乎与肺阻塞的严重程度无关，并影响患者的身体机能。
