Faverio Paola, Fumagalli Alessia, Conti Sara, Madotto Fabiana, Bini Francesco, Harari Sergio, Mondoni Michele, Oggionni Tiberio, Barisione Emanuela, Ceruti Paolo, Papetti Maria Chiara, Bodini Bruno Dino, Caminati Antonella, Valentino Angela, Centanni Stefano, Noè Donatella, Della Zoppa Matteo, Crotti Silvia, Grosso Marco, Sukkar Samir Giuseppe, Modina Denise, Andreoli Marco, Nicali Roberta, Suigo Giulia, De Giacomi Federica, Busnelli Sara, Cattaneo Elena, Mantovani Lorenzo Giovanni, Cesana Giancarlo, Pesci Alberto, Luppi Fabrizio
Respiratory Unit, School of Medicine and Surgery, University of Milano Bicocca, San Gerardo Hospital, ASST Monza, Monza, Italy.
These authors contributed equally.
ERJ Open Res. 2022 Mar 7;8(1). doi: 10.1183/23120541.00443-2021. eCollection 2022 Jan.
Nutritional status impacts quality of life and prognosis of patients with respiratory diseases, including idiopathic pulmonary fibrosis (IPF). However, there is a lack of studies performing an extensive nutritional assessment of IPF patients. This study aimed to investigate the nutritional status and to identify nutritional phenotypes in a cohort of IPF patients at diagnosis.
Patients underwent a thorough pulmonary and nutritional evaluation including questionnaires on nutritional status, and physical activity, anthropometry, body impedance, dynamometry, 4-m gait speed and blood tests.
90 IPF patients (78.9% males, mean age 72.7 years) were enrolled. The majority of patients were classified as Gender-Age-Physiology Index stage 2 (47, 52.2%) with an inactive lifestyle according to International Physical Activity Questionnaire score (39, 43.3%), and had mean forced vital capacity and diffusing capacity for carbon monoxide 86.5% and 54.2%, respectively. In regards to nutritional phenotypes, the majority of patients were normally nourished (67.8%, 95% CI 58.6-77.7%), followed by non-sarcopenic obese (25.3%, 95% CI 16.1-35.2%), sarcopenic (4.6%, 95% CI 0.0-14.5%) and sarcopenic obese (2.3%, 95% CI 0.0-12.2%). Among the normally nourished, 49.2% showed early signs of nutritional and physical performance alterations, including body mass index ≥30 kg·m in 4.3%, history of weight loss ≥5% in 11.9%, and reduction of gait speed and hand grip strength in 11.9% and 35.6%, respectively. Low vitamin D values were observed in 56.3% of cases.
IPF patients at diagnosis are mainly normally nourished and obese, but early signs of nutritional and physical performance impairment can already be identified at this stage.
营养状况会影响包括特发性肺纤维化（IPF）在内的呼吸系统疾病患者的生活质量和预后。然而，缺乏对IPF患者进行全面营养评估的研究。本研究旨在调查一组IPF患者在诊断时的营养状况并确定营养表型。
患者接受了全面的肺部和营养评估，包括关于营养状况、身体活动的问卷调查，人体测量、身体阻抗、握力测试、4米步速测试和血液检查。
纳入了90例IPF患者（男性占78.9%，平均年龄72.7岁）。根据国际体力活动问卷评分，大多数患者被归类为性别-年龄-生理指数2期（47例，52.2%），生活方式不活跃（39例，43.3%），平均用力肺活量和一氧化碳弥散量分别为86.5%和54.2%。关于营养表型，大多数患者营养正常（67.8%，95%可信区间58.6 - 77.7%），其次是非肌肉减少性肥胖（25.3%，95%可信区间16.1 - 35.2%）、肌肉减少症（4.6%，95%可信区间0.0 - 14.5%）和肌肉减少性肥胖（2.3%，95%可信区间0.0 - 12.2%）。在营养正常的患者中，49.2%表现出营养和身体机能改变的早期迹象，包括4.3%的体重指数≥30kg·m²，11.9%的体重减轻史≥5%，以及11.9%和35.6%的步速和握力下降。56.3%的病例维生素D值较低。
IPF患者在诊断时主要营养正常且肥胖，但在此阶段已可识别出营养和身体机能损害的早期迹象。
