Applied Nutrition and Dietetics, Department of Public Health, "Federico II" University of Naples Medical School, Italy.
Applied Nutrition and Dietetics, Department of Public Health, "Federico II" University of Naples Medical School, Italy.
Respir Med. 2018 Jan;134:1-5. doi: 10.1016/j.rmed.2017.11.006. Epub 2017 Nov 17.
Various criteria have been used so far for the diagnosis of malnutrition or sarcopenia in patients suffering from chronic obstructive pulmonary disease (COPD).
To determine the prevalence of malnutrition and sarcopenia in COPD, as defined by international diagnostic criteria, and determine their relationships with raw BIA variables.
Two-hundred and sixty-three COPD patients (185 males and 78 females) underwent both clinical examination and respiratory, anthropometric, bioelectrical impedance analysis (BIA raw variables: phase angle and impedance ratio), handgrip strength (HGS), 4 m gait speed and biochemical measurements. Malnutrition and sarcopenia were diagnosed based on European Society for Clinical Nutrition and Metabolism (ESPEN) criteria and European Working Group on Sarcopenia in Older People (EWGSOP) criteria, respectively.
The overall prevalence of malnutrition and sarcopenia was 19.8% and 24.0% respectively, increasing with disease severity. The prevalence of sarcopenia was significantly higher in patients with malnutrition (71.2% vs 12.3%; p < 0.001), especially in those with systemic inflammation (cachectic patients) (85.7% vs 61.3%; p < 0.001). Malnourished patients with sarcopenia had a significant reduction in BMI, fat-free mass and HGS compared to non-sarcopenic patients. Finally, impedance ratio significantly increased and phase angle decreased in patients with severe sarcopenia and in cachectic patients.
A relatively high prevalence of malnutrition and sarcopenia was found in COPD patients applying international standard criteria, with some discrepancy between the two diagnoses. In addition, clear-cut changes in raw BIA variables were observed in malnourished patients with systemic inflammation and sarcopenic patients.
目前，用于诊断患有慢性阻塞性肺疾病（COPD）的患者营养不良或肌肉减少症的标准各不相同。
根据国际诊断标准，确定 COPD 患者营养不良和肌肉减少症的患病率，并确定它们与原始 BIA 变量的关系。
263 名 COPD 患者（185 名男性和 78 名女性）接受了临床检查和呼吸、人体测量学、生物电阻抗分析（BIA 原始变量：相位角和阻抗比）、握力（HGS）、4 米步行速度和生化测量。根据欧洲临床营养与代谢学会（ESPEN）标准和欧洲老年人肌肉减少症工作组（EWGSOP）标准分别诊断营养不良和肌肉减少症。
营养不良和肌肉减少症的总体患病率分别为 19.8%和 24.0%，且随着疾病严重程度的增加而增加。营养不良患者的肌肉减少症患病率明显更高（71.2%比 12.3%；p<0.001），尤其是存在全身炎症（恶病质患者）的患者（85.7%比 61.3%；p<0.001）。与非肌肉减少症患者相比，患有肌肉减少症的营养不良患者的 BMI、去脂体重和 HGS 显著降低。最后，在严重肌肉减少症和恶病质患者中，阻抗比显著增加，相位角降低。
应用国际标准标准，COPD 患者中发现营养不良和肌肉减少症的患病率相对较高，两种诊断之间存在一定差异。此外，在存在全身炎症的营养不良患者和肌肉减少症患者中，原始 BIA 变量发生了明显变化。
