Department of Palliative Medicine, Poznan University of Medical Sciences, 61-245 Poznan, Poland.
Nutrients. 2021 Dec 23;14(1):44. doi: 10.3390/nu14010044.
Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the world population. In addition to airflow obstruction, COPD is associated with multiple systemic manifestations, including impaired nutritional status or malnutrition and changes in body composition (low muscle mass, LMM). Poor nutritional status and sarcopenia in subjects with COPD leads to a worse prognosis and increases health-related costs. Data from previous studies indicate that 30-60% of subjects with COPD are malnourished, 20-40% have low muscle mass, and 15-21.6% have sarcopenia. This study aimed to assess the prevalence of malnutrition, sarcopenia, and malnutrition-sarcopenia syndrome in elderly subjects with COPD and investigate the relationship between COPD severity and these conditions.
A cross-sectional study involving 124 patients with stable COPD, aged ≥60, participating in a stationary pulmonary rehabilitation program. Nutritional status was assessed following the Global Leadership Initiative on Malnutrition (GLIM) criteria and sarcopenia with the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. The results of pulmonary function tests and exercise capacity were obtained from the hospital database.
22.6% of participants had malnutrition according to the GLIM criteria. Subjects with malnutrition had lower gait speed ( = 0.0112) and worse results of the Six Minute Walk Test. Sixteen participants (12.9%) had sarcopenia; 12 subjects with sarcopenia had concomitant malnutrition. The prevalence of severe and very severe obstruction (GOLD3/GOLD4) was 91.7%. It was significantly higher in patients with malnutrition-sarcopenia syndrome.
Malnutrition was found in nearly one out of four subjects with COPD, while sarcopenia was one out of seven patients. About 10% of our study sample had malnutrition-sarcopenia syndrome. The prevalence of severe and very severe obstruction was significantly higher in patients with malnutrition-sarcopenia syndrome.
慢性阻塞性肺疾病（COPD）是世界人口第四大致死原因。除气流受限外，COPD 还与多种全身表现相关，包括营养状况受损或营养不良以及身体成分改变（低肌肉量、LMM）。COPD 患者的营养状况差和肌少症会导致预后更差，并增加与健康相关的成本。来自先前研究的数据表明，30-60%的 COPD 患者存在营养不良，20-40%存在低肌肉量，15-21.6%存在肌少症。本研究旨在评估老年 COPD 患者营养不良、肌少症和营养不良-肌少症综合征的患病率，并探讨 COPD 严重程度与这些情况之间的关系。
这是一项横断面研究，共纳入 124 名年龄≥60 岁、参加固定肺康复计划的稳定期 COPD 患者。根据全球营养不良倡议（GLIM）标准评估营养状况，根据欧洲老年人肌少症工作组 2（EWGSOP2）标准评估肌少症。肺功能测试和运动能力的结果来自医院数据库。
根据 GLIM 标准，22.6%的参与者存在营养不良。存在营养不良的受试者步速较慢（=0.0112），六分钟步行试验结果较差。16 名参与者（12.9%）存在肌少症；12 名肌少症患者存在伴发性营养不良。严重和非常严重阻塞（GOLD3/GOLD4）的患病率为 91.7%。在营养不良-肌少症综合征患者中，这一比例显著更高。
在近四分之一的 COPD 患者中发现存在营养不良，而在七分之一的患者中存在肌少症。我们研究样本中约有 10%的患者存在营养不良-肌少症综合征。在营养不良-肌少症综合征患者中，严重和非常严重阻塞的患病率显著更高。
