Sarıkaya Buse, Aktaç Şule, Çetinkaya Erdoğan
Department of Nutrition and Dietetics, Faculty of Health Sciences, Amasya University, Amasya, Turkey.
Department of Nutrition and Dietetics, Faculty of Health Sciences, Marmara University, Istanbul, Turkey.
Nutr Clin Pract. 2025 Jun 18. doi: 10.1002/ncp.11331.
Nutrition screening is crucial in chronic obstructive pulmonary disease (COPD) management. This study aimed to assess the nutritional status of patients with COPD at different severity levels.
This cross-sectional study included 52 patients with COPD aged 50-80 years. COPD severity was classified according to forced expiratory volume in 1 s (FEV) using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. Nutritional status was assessed using a two-step approach: initial screening with the Mini Nutritional Assessment-Short Form (MNA-SF), followed by malnutrition diagnosis in at-risk individuals according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. Body composition was assessed using the bioelectrical impedance analysis (BIA) method.
The MNA-SF identified 23.1% of patients as at risk, whereas GLIM diagnosed malnutrition in 13.5%. Compared to the well-nourished group, malnourished patients had significantly lower body mass index (BMI) (21.4 ± 3.7 vs 26.8 ± 3.2 kg/m; P < 0.05) and skeletal muscle mass (22.3 ± 3.3 vs 27.7 ± 3.2 kg; P < 0.05). Patients with severe COPD had lower BMI and fat-free mass index (FFMI) than those with moderate COPD (P < 0.05). Malnutrition was associated with prolonged hospital stays (7.7 ± 5.7 vs 5.8 ± 3.2 days; P < 0.05) and lower FEV values (P < 0.05).
The MNA-SF does not consider disease-specific factors, whereas GLIM, despite incorporating muscle mass evaluation, is influenced by COPD-related complications. A comprehensive approach that accounts for COPD-related physiological changes is needed for accurate malnutrition assessment.
营养筛查在慢性阻塞性肺疾病（COPD）管理中至关重要。本研究旨在评估不同严重程度的COPD患者的营养状况。
这项横断面研究纳入了52例年龄在50 - 80岁的COPD患者。根据慢性阻塞性肺疾病全球倡议（GOLD）标准，使用第1秒用力呼气量（FEV）对COPD严重程度进行分类。营养状况采用两步法评估：首先使用微型营养评定简表（MNA-SF）进行初步筛查，然后根据全球营养不良领导倡议（GLIM）标准对有风险的个体进行营养不良诊断。使用生物电阻抗分析（BIA）方法评估身体成分。
MNA-SF确定23.1%的患者有风险，而GLIM诊断出13.5%的患者营养不良。与营养良好组相比，营养不良患者的体重指数（BMI）显著更低（21.4±3.7 vs 26.8±3.2 kg/m²；P<0.05）和骨骼肌质量更低（22.3±3.3 vs 27.7±3.2 kg；P<0.05）。重度COPD患者的BMI和去脂体重指数（FFMI）低于中度COPD患者（P<0.05）。营养不良与住院时间延长（7.7±5.7 vs 5.8±3.2天；P<0.05）和更低的FEV值相关（P<0.05）。
MNA-SF未考虑疾病特异性因素，而GLIM尽管纳入了肌肉质量评估，但受COPD相关并发症影响。需要一种综合考虑COPD相关生理变化的方法来准确评估营养不良。
