Čekerevac Ivan, Lazić Zorica
Srp Arh Celok Lek. 2011 May-Jun;139(5-6):322-7. doi: 10.2298/sarh1106322c.
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 recognised. 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).
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.
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.
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).
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.
营养异常对慢性阻塞性肺疾病（COPD）具有最重要的系统性影响之一。COPD与肥胖之间的关系已被观察到并得到认可。在COPD患者中，除了总体重变化外，去脂体重（FFM）的减少也可能导致身体成分的改变。
本研究旨在评估肥胖及身体成分变化对COPD患者肺功能、呼吸困难程度和生活质量的影响。
对79例处于稳定期的COPD患者进行评估。评估肺功能和动脉血气分析。根据体重指数（BMI）分析营养状况。通过使用去脂体重指数（FFMI）进行人体测量来评估身体成分。使用圣乔治呼吸问卷（SGRQ）评估生活质量。使用视觉模拟量表（VAS）评估呼吸困难程度。
轻度COPD患者中肥胖的患病率最高（50.0%），而极重度COPD患者中肥胖的患病率最低（10.0%）。22.2%体重正常的COPD患者和9.0%超重的COPD患者出现了FFM减少。与其他COPD患者相比，肥胖患者的生活质量较低。肥胖患者的呼吸困难程度也更高。肥胖患者的气流阻塞程度最低（p = 0.023）。我们发现第一秒用力呼气量（FEV1%）与BMI之间存在显著正相关（r = 0.326，p = 0.003），FEV1%与FFMI之间也存在显著正相关（r = 0.321，p = 0.004）。
轻度COPD患者中肥胖的患病率最高。与其他COPD患者相比，肥胖的COPD患者气流阻塞程度最低，呼吸困难程度更高，生活质量更低。
