School of Health Studies, Western University, London, Ontario, Canada.
School of Food and Nutritional Sciences, Brescia University College at Western University, London, Ontario, Canada.
Nutr Clin Pract. 2021 Aug;36(4):891-898. doi: 10.1002/ncp.10651. Epub 2021 Mar 31.
Patients with interstitial lung disease (ILD) are known to have diminished exercise ability. This study aimed to explore the relationship between nutrition status and body composition parameters with exercise capacity in ILD patients. A second aim focused on assessing the appropriateness of surrogate markers of nutrition status in ILD patients.
Disease severity was determined by the percentage of predicted forced vital capacity. Exercise capacity was determined using 6-minute walk distance. Nutrition status was assessed using the subjective global assessment (SGA), standardized phase angle (SPhA), and impedance ratio z-score (z-IR). Bioelectrical impedance analysis estimated body composition parameters.
45 of 79 participants (57%) were malnourished according to the SGA. FFM index z-score (z-FFMI) (r = 0.42, P = .02) and SGA (r = 0.49, P < .01) were significant predictors of exercise capacity independent of disease severity. Age (odds ratio [OR] = 1.1; 95% CI, 1.01-1.25; P = .04), low body mass index (OR = 0.73; 95% CI, 0.57-0.92; P = .01), z-FFMI (OR = 0.34; 95% CI, 0.17-0.68; P < .01), and body fat mass index z-score (OR = 0.39; 95% CI, 0.17-0.91; P = .03) were significantly associated with severe malnutrition. There was no significant difference in SPhA across SGA groups; however, a higher z-IR (poorer cell health) significantly increased the odds of severe malnutrition (OR = 2.75; 95% CI, 1.27-6.03; P = .02).
In ILD patients, malnutrition and loss of FFM negatively impact the ability to perform activities of daily living.
患有间质性肺病（ILD）的患者已知运动能力下降。本研究旨在探讨营养状况和身体成分参数与ILD 患者运动能力之间的关系。第二个目的是评估ILD 患者营养状况替代标志物的适宜性。
通过预测用力肺活量的百分比确定疾病严重程度。使用 6 分钟步行距离确定运动能力。使用主观整体评估（SGA）、标准化相位角（SPhA）和阻抗比 z 分数（z-IR）评估营养状况。生物电阻抗分析估计身体成分参数。
根据 SGA，79 名参与者中有 45 名（57%）存在营养不良。FFM 指数 z 分数（z-FFMI）（r = 0.42，P =.02）和 SGA（r = 0.49，P <.01）是独立于疾病严重程度预测运动能力的重要指标。年龄（比值比 [OR] = 1.1；95%可信区间，1.01-1.25；P =.04）、低体重指数（OR = 0.73；95%可信区间，0.57-0.92；P =.01）、z-FFMI（OR = 0.34；95%可信区间，0.17-0.68；P <.01）和体脂肪质量指数 z 分数（OR = 0.39；95%可信区间，0.17-0.91；P =.03）与严重营养不良显著相关。SGA 组之间 SPhA 没有显著差异；然而，较高的 z-IR（细胞健康状况较差）显著增加了严重营养不良的几率（OR = 2.75；95%可信区间，1.27-6.03；P =.02）。
在 ILD 患者中，营养不良和去脂肪体重的丢失会对日常生活活动能力产生负面影响。
