Khan Naushad Ahmad, Kumar Naresh, Daga Mradul K
Department of Medicine, Maulana Azad Medical College, New Delhi, India.
Tanaffos. 2016;15(4):225-235.
Malnutrition is very common in patients with chronic obstructive pulmonary disease (COPD). Nutritional supplementation improves the patient's nutritional status by increasing the energy intake and providing anti-inflammatory elements which can relieve the patient's symptoms and delay the disease progression. This study sought to determine if energy and protein supplementation improves physical function, pulmonary function and health-related quality of life (HRQL) in stable COPD patients.
The study was carried out in an outpatient setting on 60 stable COPD patients over a period of one year. Patients were randomized to intervention group (n=30), receiving supplemental nutrition in the form of additional protein and carbohydrates or control group (n=30), receiving only the usual standard diet. Lung function, body mass index (BMI), exercise capacity (6-minute walk test or 6MWT), mid-upper arm circumference (MUAC) and skin fold thickness (SFT) were evaluated, and clinical assessment was carried out at baseline and after completion of 12 weeks. The HRQL was assessed using Seattle obstructive lung disease questionnaire.
Twelve weeks of dietary supplementation resulted in a significant increase in weight and BMI of patients in the intervention group in comparison to the control group (P<0.005). Significant improvement was also observed in 6MWT and HRQL scores after nutritional intervention (P=0.002 and P=0.001, respectively). However, difference in MUAC, SFT and serum protein level after 12 weeks of follow up was not significant in any of the two groups. There was a similar degree of lung function improvement in both groups although it was not statistically significant.
Nutritional supplementation with high protein and energy diet during 12 weeks of intervention improved body weight and composition, exercise capacity and quality of life in stable COPD patients.
营养不良在慢性阻塞性肺疾病(COPD)患者中非常常见。营养补充通过增加能量摄入和提供抗炎成分来改善患者的营养状况,从而缓解患者症状并延缓疾病进展。本研究旨在确定能量和蛋白质补充是否能改善稳定期COPD患者的身体功能、肺功能和健康相关生活质量(HRQL)。
该研究在门诊环境中对60例稳定期COPD患者进行了为期一年的研究。患者被随机分为干预组(n = 30),接受额外蛋白质和碳水化合物形式的补充营养,或对照组(n = 30),仅接受常规标准饮食。评估肺功能、体重指数(BMI)、运动能力(6分钟步行试验或6MWT)、上臂中部周长(MUAC)和皮褶厚度(SFT),并在基线和12周结束后进行临床评估。使用西雅图阻塞性肺疾病问卷评估HRQL。
与对照组相比,干预组患者经过12周的饮食补充后体重和BMI显著增加(P < 0.005)。营养干预后6MWT和HRQL评分也有显著改善(分别为P = 0.002和P = 0.001)。然而,随访12周后,两组患者的MUAC、SFT和血清蛋白水平差异均无统计学意义。两组肺功能改善程度相似,尽管无统计学意义。
在12周的干预期间,补充高蛋白和高能量饮食可改善稳定期COPD患者的体重、身体组成、运动能力和生活质量。