Dhakal Niraj, Lamsal Madhab, Baral Nirmal, Shrestha Shrijana, Dhakal Subodh Sagar, Bhatta Narendra, Dubey Raju Kumar
Lecturer, Department of Biological Sciences, Regional College of Science and Technology , Pokhara, Nepal .
Professor, Department of Biochemistry, B.P. Koirala Institute of Health Sciences (BPKIHS) , Dharan, Nepal .
J Clin Diagn Res. 2015 Feb;9(2):BC01-4. doi: 10.7860/JCDR/2015/9426.5511. Epub 2015 Feb 1.
Oxidative stress and malnutrition are shown to have pathogenic effect in Chronic Obstructive Pulmonary Disease (COPD).
This study was done to assess the burden of oxidative stress in COPD and to determine its relation to their nutritional status.
In this cross-sectional study, 100 COPD cases from emergency and medical ward and meeting inclusion criteria, along with age, sex and occupation (mainly farmers, housewives and drivers) matched 100 controls without COPD and meeting inclusion criteria were enrolled. Oxidative stress was assessed by measuring lipid peroxidation product, Malondialdehyde (MDA) and antioxidants, like Vitamin C, E and Red Blood Cell Catalase (RBCC). Mini Nutritional Assessment (MNA) tool and Body Mass Index (BMI) were used to assess nutritional status.
Chi-square test was applied for categorical variable. Student t-test was applied for comparison of means. Analysis of Variance (ANOVA) was applied for comparison between groups followed by Bonferroni post hoc analysis. Pearson correlation method was used for quantitative variables. Statistical significance was defined as p< 0.05 (two tailed).
COPD cases had significantly high MDA level with low level of Vitamin E and catalase as compared to controls (p < 0.001). Most of the COPD cases were underweight (BMI ≤ 18.5 Kg/m(2)) and malnourished (MNA score less than 7). Bonferroni post-hoc analysis, showed significantly high burden of oxidative stress in underweight and malnourished cases as compared to normal weight (p < 0.05) among COPD cases. Highly significant correlation was seen between BMI and plasma MDA level (r = -0.27, p = 0.008) in COPD cases.
This study shows impaired oxidant/antioxidant balance along with malnutrition and underweight in COPD, which signals for considering antioxidant therapy along with nutritional management.
氧化应激和营养不良在慢性阻塞性肺疾病（COPD）中具有致病作用。
本研究旨在评估COPD患者氧化应激的负担，并确定其与营养状况的关系。
在这项横断面研究中，纳入了100例来自急诊科和内科病房且符合纳入标准的COPD患者，同时纳入了100例年龄、性别和职业（主要为农民、家庭主妇和司机）相匹配且符合纳入标准的无COPD对照者。通过测量脂质过氧化产物丙二醛（MDA）以及抗氧化剂，如维生素C、维生素E和红细胞过氧化氢酶（RBCC）来评估氧化应激。使用微型营养评定（MNA）工具和体重指数（BMI）来评估营养状况。
分类变量采用卡方检验。均数比较采用学生t检验。组间比较采用方差分析（ANOVA），随后进行Bonferroni事后分析。定量变量采用Pearson相关法。统计学显著性定义为p < 0.05（双侧）。
与对照组相比，COPD患者的MDA水平显著升高，而维生素E和过氧化氢酶水平降低（p < 0.001）。大多数COPD患者体重过轻（BMI≤18.5 Kg/m²）且营养不良（MNA评分低于7分）。Bonferroni事后分析显示，与体重正常的COPD患者相比，体重过轻和营养不良的患者氧化应激负担显著更高（p < 0.05）。在COPD患者中，BMI与血浆MDA水平之间存在高度显著的相关性（r = -0.27，p = 0.008）。
本研究表明COPD患者存在氧化/抗氧化平衡受损以及营养不良和体重过轻的情况，这表明在营养管理的同时应考虑抗氧化治疗。
