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Zhang X, Wang Y, Xu M, Zhang Y, Lyu Q. The malnutrition in AECOPD and its association with unfavorable outcomes by comparing PNI, GNRI with the GLIM criteria: a retrospective cohort study. Front Nutr 2024; 11:1365462. [PMID: 39183991 PMCID: PMC11341410 DOI: 10.3389/fnut.2024.1365462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 07/30/2024] [Indexed: 08/27/2024] Open
Abstract
Introduction The management of nutritional risk has garnered significant attention in individuals diagnosed with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) due to the high prevalence of malnutrition and its correlation with unfavorable outcomes. While numerous rating scales exist to assist in assessment for both clinical and research purposes, there is considerable variability in the selection of scales based on the characteristics of the study participants and the study design. The objective of this study was to examine the efficacy of the Geriatric Nutritional Risk Index (GNRI) and Prognostic Nutritional Index (PNI) in identifying malnutrition and predicting prognosis in elderly AECOPD patients. Methods From January 2022 to December 2022, a consecutive inclusion of elderly AECOPD patients admitted to the First Affiliated Hospital of Zhengzhou University was conducted. Diagnosing malnutrition in patients using PNI and GNRI, comparing the results with the diagnostic outcomes based on the Global Leadership Initiative on Malnutrition (GLIM) criteria through Receiver Operating Characteristic curves. Logistic regression analysis was employed to assess the risks associated with length of stay (LOS), hospitalization costs, and Charlson Comorbidity Index (CCI) based on GLIM, GNRI, or PNI. Results A total of 839 elderly AECOPD patients were investigated in the study. The GNRI and PNI demonstrated a sensitivity of 89.5 and 74.1%, specificity of 77.2 and 66.4%, and an area under the curve of 0.834 and 0.702, respectively. The identification of high malnutrition-risk cases using the GLIM, GNRI and PNI were associated with a significant increase in the risk of LOS over 7 days [odds ratio (95% CI) for GLIM, GNRI, PNI: 1.376 (1.033-1.833); 1.405 (1.070-1.846); 1.875 (1.425-2.468)] and higher hospitalization expenses [OR (95% CI) for GLIM, GNRI: 1.498 (1.080-2.080); 1.510 (1.097-2.079)], but not with the CCI. Conclusion According to our study, it is possible to use GNRI and PNI as alternatives to GLIM in the context of AECOPD, which makes it easier to identify malnutrition. The utilization of GNRI and PNI as alternatives to GLIM in the context of AECOPD enables the identification of malnutrition. The presence of malnourished individuals experiencing AECOPD is correlated with higher probabilities of extended hospital stays and escalated in-hospital expenses.
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Affiliation(s)
- Xueyang Zhang
- College of Public Health, Zhenghou University, Zhengzhou, Henan, China
| | - Yu Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Henan Key Laboratory for Pharmacology of Liver Diseases, Zhengzhou, China
| | - Minmin Xu
- College of Public Health, Zhenghou University, Zhengzhou, Henan, China
| | - Yuanyi Zhang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Quanjun Lyu
- College of Public Health, Zhenghou University, Zhengzhou, Henan, China
- Zhengzhou Shuqing Medical College, Zhengzhou, Henan, China
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2
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de Oliveira Bezerra MR, de Sousa IM, Miranda AL, Ferreira GMC, Chaves GV, Verde SMML, Maurício SF, da Costa Pereira JP, Gonzalez MC, Prado CM, Fayh APT. Age-adjusted Charlson comorbidity index and its association with body composition and overall survival in patients with colorectal cancer. Support Care Cancer 2024; 32:517. [PMID: 39014284 DOI: 10.1007/s00520-024-08730-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 07/10/2024] [Indexed: 07/18/2024]
Abstract
OBJECTIVE To examine the relationship between the age-adjusted Charlson comorbidity index (A-CCI) with body composition and overall survival in patients newly diagnosed with colorectal cancer (CRC). RESEARCH METHODS AND PROCEDURES In this cohort study, patients (≥ 18 years old) with CRC were followed for 36 months. Computed tomography images of the third lumbar were analyzed to determine body composition, including skeletal muscle area (SMA), skeletal muscle index (SMI), skeletal muscle radiodensity (SMD), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT). Phenotypes based on comorbidity burden assessed by A-CCI and body composition parameters were established. RESULTS A total of 436 participants were included, 50% male, with a mean age of 61 ± 13.2 years. Approximately half of the patients (50.4%) had no comorbidity, and the A-CCI median score was 4 (interquartile range: 3-6). A higher A-CCI score was a risk factor for 36-month mortality (HR = 3.59, 95% CI = 2.17-5.95). Low SMA and low SMD were associated with a higher A-CCI. All abnormal phenotypes (high A-CCI and low SMA; high A-CCI and low SMD; high A-CCI and high VAT) were independently associated with higher 36-month mortality hazard (adjusted HR 5.12, 95% CI 2.73-9.57; adjusted HR 4.58, 95% CI 2.37-8.85; and adjusted HR 2.36, 95% CI 1.07-5.22, respectively). CONCLUSION The coexistence of comorbidity burden and abnormal body composition phenotypes, such as alterations in muscle or fat compartments, may pose an additional risk of mortality in patients newly diagnosed with CRC. Early assessment and management of these phenotypes could be crucial in optimizing outcomes in such patients.
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Affiliation(s)
- Mara Rúbia de Oliveira Bezerra
- Health Sciences Center, Postgraduate Program in Nutrition, Federal University of Rio Grande Do Norte, Natal, Rio Grande Do Norte, Brazil
| | - Iasmin Matias de Sousa
- Health Sciences Center, Postgraduate Program in Health Sciences, Federal University of Rio Grande Do Norte, Avenida Senador Salgado Filho, no 3000, Natal, Rio Grande Do Norte, 59078-970, Brazil
| | - Ana Lúcia Miranda
- Health Sciences Center, Postgraduate Program in Health Sciences, Federal University of Rio Grande Do Norte, Avenida Senador Salgado Filho, no 3000, Natal, Rio Grande Do Norte, 59078-970, Brazil
- Luiz Antonio Hospital, Liga Norteriograndense Contra O Câncer, Natal, Rio Grande Do Norte, Brazil
| | - Glaucia Mardrini Cassiano Ferreira
- Health Sciences Center, Postgraduate Program in Health Sciences, Federal University of Rio Grande Do Norte, Avenida Senador Salgado Filho, no 3000, Natal, Rio Grande Do Norte, 59078-970, Brazil
| | - Gabriela Villaça Chaves
- Department of Nutrition, Cancer Hospital II, National Cancer Institute José Alencar Gomes da Silva (INCA), Rio de Janeiro, Brazil
| | | | - Silvia Fernandes Maurício
- Department of Clinical and Social Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Jarson Pedro da Costa Pereira
- Postgraduate Program in Nutrition and Public Health, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - M Cristina Gonzalez
- Postgraduate Program in Nutrition and Food, Federal University of Pelotas, Pelotas, Rio Grande Do Sul, Brazil
| | - Carla M Prado
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Canada
| | - Ana Paula Trussardi Fayh
- Health Sciences Center, Postgraduate Program in Nutrition, Federal University of Rio Grande Do Norte, Natal, Rio Grande Do Norte, Brazil.
- Health Sciences Center, Postgraduate Program in Health Sciences, Federal University of Rio Grande Do Norte, Avenida Senador Salgado Filho, no 3000, Natal, Rio Grande Do Norte, 59078-970, Brazil.
- PesqClin Lab, Onofre Lopes University Hospital, Brazilian Company of Hospital Services (EBSERH), Federal University of Rio Grande Do Norte, Natal, Brazil.
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3
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Shen X, Qian R, Wei Y, Tang Z, Zhong H, Huang J, Zhang X. Prediction model and assessment of malnutrition in patients with stable chronic obstructive pulmonary disease. Sci Rep 2024; 14:6508. [PMID: 38499651 PMCID: PMC10948850 DOI: 10.1038/s41598-024-56747-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/11/2024] [Indexed: 03/20/2024] Open
Abstract
Chronic obstructive pulmonary disease (COPD) combined with malnutrition results in decreased exercise capacity and a worse quality of life. We aimed to develop an observational case-control study to explore the effective and convenient method to identify potential individuals is lacking. This study included data from 251 patients with COPD and 85 participants in the control group. Parameters and body composition were compared between groups, and among patients with varied severity. The LASSO approach was employed to select the features for fitting a logistic model to predict the risk of malnutrition in patients with stable COPD. Patients with COPD exhibited significantly lower 6-min walk distance (6MWD), handgrip strength, fat-free mass index (FFMI), skeletal muscle mass (SMM) and protein. The significant predictors identified following LASSO selection included 6MWD, waist-to-hip ratio (WHR), GOLD grades, the COPD Assessment Test (CAT) score, and the prevalence of acute exacerbations. The risk score model yielded good accuracy (C-index, 0.866 [95% CI 0.824-0.909]) and calibration (Brier score = 0.150). After internal validation, the adjusted C-index and Brier score were 0.849, and 0.165, respectively. This model may provide primary physicians with a simple scoring system to identify malnourished patients with COPD and develop appropriate rehabilitation interventions.
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Affiliation(s)
- Xurui Shen
- Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Ruiqi Qian
- Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Yuan Wei
- Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China
| | - Zhichao Tang
- Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Huafei Zhong
- Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Jianan Huang
- Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
| | - Xiuqin Zhang
- Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
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Brath MSG, Alsted SD, Sahakyan M, Mark EB, Frøkjær JB, Rasmussen HH, Østergaard LR, Christensen RB, Weinreich UM. Association between the Static and Dynamic Lung Function and CT-Derived Thoracic Skeletal Muscle Measurements-A Retrospective Analysis of a 12-Month Observational Follow-Up Pilot Study. Adv Respir Med 2024; 92:123-144. [PMID: 38525774 PMCID: PMC10961694 DOI: 10.3390/arm92020015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 02/26/2024] [Accepted: 02/28/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND Patients with chronic obstructive pulmonary disease (COPD) with low skeletal muscle mass and severe airway obstruction have higher mortality risks. However, the relationship between dynamic/static lung function (LF) and thoracic skeletal muscle measurements (SMM) remains unclear. This study explored patient characteristics (weight, BMI, exacerbations, dynamic/static LF, sex differences in LF and SMM, and the link between LF and SMM changes. METHODS A retrospective analysis of a 12-month prospective follow-up study patients with stable COPD undergoing standardized treatment, covering mild to severe stages, was conducted. The baseline and follow-up assessments included computed tomography and body plethysmography. RESULTS This study included 35 patients (17 females and 18 males). This study revealed that females had more stable LF but tended to have greater declines in SMM areas and indices than males (-5.4% vs. -1.9%, respectively), despite the fact that females were younger and had higher LF and less exacerbation than males. A multivariate linear regression showed a negative association between the inspiratory capacity/total lung capacity ratio (IC/TLC) and muscle fat area. CONCLUSIONS The findings suggest distinct LF and BC progression patterns between male and female patients with COPD. A low IC/TLC ratio may predict increased muscle fat. Further studies are necessary to understand these relationships better.
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Affiliation(s)
- Mia Solholt Godthaab Brath
- Respiratory Research Aalborg (Reaal), Aalborg University Hospital, 9000 Aalborg, Denmark;
- Department of Clinical Medicine, Aalborg University, 9220 Aalborg, Denmark; (E.B.M.); (J.B.F.); (H.H.R.)
- Department of Respiratory Diseases, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - Sisse Dyrman Alsted
- Department of General Medicine, North Region Hospital–Hjørring, 9800 Hjørring, Denmark;
| | - Marina Sahakyan
- Department of Radiology, Aalborg University Hospital, 9000 Aalborg, Denmark; (M.S.); (R.B.C.)
| | - Esben Bolvig Mark
- Department of Clinical Medicine, Aalborg University, 9220 Aalborg, Denmark; (E.B.M.); (J.B.F.); (H.H.R.)
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - Jens Brøndum Frøkjær
- Department of Clinical Medicine, Aalborg University, 9220 Aalborg, Denmark; (E.B.M.); (J.B.F.); (H.H.R.)
- Department of Radiology, Aalborg University Hospital, 9000 Aalborg, Denmark; (M.S.); (R.B.C.)
| | - Henrik Højgaard Rasmussen
- Department of Clinical Medicine, Aalborg University, 9220 Aalborg, Denmark; (E.B.M.); (J.B.F.); (H.H.R.)
- Department of Gastroenterology and Hepatology, Aalborg University Hospital, 9000 Aalborg, Denmark
- Danish Nutrition Science Center, Aalborg University Hospital, 9000 Aalborg, Denmark
- Center for Nutrition and Intestinal Failure, Aalborg University Hospital, 9000 Aalborg, Denmark
- Department of Dietetic and Nutritional Research, Copenhagen University Hospitals, Herlev and Gentofte Hospitals, 2730 Herlev, Denmark
| | - Lasse Riis Østergaard
- Medical Informatics Group, Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark;
| | | | - Ulla Møller Weinreich
- Respiratory Research Aalborg (Reaal), Aalborg University Hospital, 9000 Aalborg, Denmark;
- Department of Clinical Medicine, Aalborg University, 9220 Aalborg, Denmark; (E.B.M.); (J.B.F.); (H.H.R.)
- Department of Respiratory Diseases, Aalborg University Hospital, 9000 Aalborg, Denmark
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5
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Yogesh M, Patel J, Makwana N, Mody M. The triad of physiological challenges: investigating the intersection of sarcopenia, malnutrition, and malnutrition-sarcopenia syndrome in patients with COPD - a cross-sectional study. BMC Pulm Med 2024; 24:71. [PMID: 38317093 PMCID: PMC10840248 DOI: 10.1186/s12890-024-02884-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 01/25/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND One of the most prevalent respiratory disorders in modern society is chronic obstructive pulmonary disease (COPD). Frequent comorbidities in patients with COPD are abnormal nutritional status and body composition variations. Malnutrition-sarcopenia syndrome, which occurs when the 2 conditions - malnutrition and sarcopenia - coexist, raises the risk of death more than either condition alone. The current study sought to determine the prevalence of malnutrition, sarcopenia, and malnutrition-sarcopenia syndrome in patients with COPD as well as the association between these diseases and the severity of COPD. METHODS The study was an analytical cross-sectional study conducted on hospitalized patients with COPD. The sample size of the study was calculated to be 160. A self-structured questionnaire was used to collect the data, containing sociodemographic characteristics, clinical profiles, anthropometric assessment, and bioimpedance indices. Sarcopenia was diagnosed with low muscle strength and muscle mass by the EWGSOP2 recommendations. Muscle mass is measured by BIA and muscle strength (Handgrip) was measured by a Hand Dynamometer. Assessment of the risk of malnutrition was performed using the Mini Nutritional Assessment-Short Form questionnaire and was confirmed by GLIM criteria. The COPD assessment test (CAT) tool determined the severity of the condition. For the data analysis, comparisons were made using Student's t test and Mann-Whitney test in bivariate analysis. Multivariate logistic regression analyses were performed considering the outcomes of patients with COPD by CAT scores, prolonged length of stay, and hospital readmission 6 months after discharge. RESULTS The mean age of the participants was 48 ± 5 years. Approximately 61.9% were found to be sarcopenic. Approximately 45.6% of participants had malnutrition. Malnutrition sarcopenia syndrome was diagnosed in 32.5% of patients. The study analysis revealed that patients with COPD with malnutrition-sarcopenia syndrome had more than twice the odds of prolonged hospital stay, re-admission within 6 months, and higher CAT scores. CONCLUSION The study revealed a high prevalence of sarcopenia, malnutrition, and malnutrition sarcopenia syndrome in patients with COPD. These conditions were found to be statistically significant with prolonged length of stay, re-admission within 6 months, and CAT scores. The findings highlight the importance of addressing these conditions as part of the management of the patients.
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Affiliation(s)
- M Yogesh
- Department of Community Medicine, Shri M P Shah Government Medical College, Jamnagar, Gujarat, India
| | - Jenish Patel
- Shri M P Shah Government Medical College, Jamnagar, Gujarat, 361008, India
| | - Naresh Makwana
- Department of Community Medicine, Shri M P Shah Government Medical College, Jamnagar, Gujarat, India
| | - Mansi Mody
- Shri M P Shah Government Medical College, Jamnagar, Gujarat, 361008, India.
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6
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Tramontano A, Palange P. Nutritional State and COPD: Effects on Dyspnoea and Exercise Tolerance. Nutrients 2023; 15:nu15071786. [PMID: 37049625 PMCID: PMC10096658 DOI: 10.3390/nu15071786] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 03/30/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023] Open
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a disease that is spreading worldwide and is responsible for a huge number of deaths annually. It is characterized by progressive and often irreversible airflow obstruction, with a heterogeneous clinical manifestation based on disease severity. Along with pulmonary impairment, COPD patients display different grades of malnutrition that can be linked to a worsening of respiratory function and to a negative prognosis. Nutritional impairment seems to be related to a reduced exercise tolerance and to dyspnoea becoming a major determinant in patient-perceived quality of life. Many strategies have been proposed to limit the effects of malnutrition on disease progression, but there are still limited data available to determine which of them is the best option to manage COPD patients. The purpose of this review is to highlight the main aspects of COPD-related malnutrition and to underline the importance of poor nutritional state on muscle energetics, exercise tolerance and dyspnoea.
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Affiliation(s)
- Angela Tramontano
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
- Respiratory and Critical Care, Policlinico Umberto I Hospital, 00161 Rome, Italy
| | - Paolo Palange
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
- Respiratory and Critical Care, Policlinico Umberto I Hospital, 00161 Rome, Italy
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7
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Ponce J, Anzalone AJ, Bailey K, Sayles H, Timmerman M, Jackson M, McClay J, Hanson C. Impact of malnutrition on clinical outcomes in patients diagnosed with COVID-19. JPEN J Parenter Enteral Nutr 2022; 46:1797-1807. [PMID: 35672915 PMCID: PMC9347569 DOI: 10.1002/jpen.2418] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 05/23/2022] [Accepted: 05/28/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is now the third leading cause of death in the United States. Malnutrition in hospitalized patients increases risk of complications. However, the effect of malnutrition on outcomes in patients infected is unclear. This study aims to identify the impact of malnutrition on mortality and adverse hospital events in patients hospitalized with COVID-19. METHODS This study used data from the National COVID Cohort Collaborative (N3C), a COVID-19 repository containing harmonized, longitudinal electronic health record data from US health systems. Malnutrition was categorized into three groups based on condition diagnosis: (1) none documented, (2) history of malnutrition, and (3) hospital-acquired malnutrition. Multivariable logistic regression was performed to determine whether malnutrition was associated with mortality and adverse events, including mechanical ventilation, acute respiratory distress syndrome, extracorporeal membrane oxygenation, and hospital-acquired pressure injury, in hospitalized patients with COVID-19. RESULTS Of 343,188 patients hospitalized with COVID-19, 11,206 had a history of malnutrition and 15,711 had hospital-acquired malnutrition. After adjustment for potential confounders, odds of mortality were significantly higher in patients with a history of malnutrition (odds ratio [OR], 1.71; 95% confidence interval [CI], 1.63-1.79; P < 0.001) and hospital-acquired malnutrition (OR, 2.5; 95% CI, 2.4-2.6; P < 0.001). Adjusted odds of adverse hospital events were also significantly elevated in both malnutrition groups. CONCLUSIONS Results indicate the risk of mortality and adverse inpatient events in adults with COVID-19 is significantly higher in patients with malnutrition. Prevention, diagnosis, and treatment of malnutrition could be a key component in improving outcomes in these patients.
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Affiliation(s)
- Jana Ponce
- University of Nebraska Medical Center, College of Allied Health Professions, Omaha, Nebraska, USA
- Department of Pharmaceutical and Nutrition Care, Nebraska Medicine, Omaha, Nebraska, USA
| | - Alfred Jerrod Anzalone
- Department of Neurological Sciences, University of Nebraska Medical Center, College of Medicine, Omaha, Nebraska, USA
- Great Plains IDeA-CTR, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Kristina Bailey
- Department of Internal Medicine, University of Nebraska Medical Center, College of Medicine, Omaha, Nebraska, USA
- Veterans Administration Nebraska-Iowa Health Systems, Omaha, Nebraska, USA
| | - Harlan Sayles
- Department of Biostatistics, University of Nebraska Medical Center, College of Public Health, Omaha, Nebraska, USA
| | - Megan Timmerman
- University of Nebraska Medical Center, College of Allied Health Professions, Omaha, Nebraska, USA
- Department of Pharmaceutical and Nutrition Care, Nebraska Medicine, Omaha, Nebraska, USA
| | - Mariah Jackson
- University of Nebraska Medical Center, College of Allied Health Professions, Omaha, Nebraska, USA
| | - James McClay
- Department of Emergency Medicine, University of Nebraska Medical Center, College of Medicine, Omaha, Nebraska, USA
| | - Corrine Hanson
- University of Nebraska Medical Center, College of Allied Health Professions, Omaha, Nebraska, USA
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8
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The Nutritional Status of Chronic Obstructive Pulmonary Disease Exacerbators. Can Respir J 2022; 2022:3101486. [PMID: 36276928 PMCID: PMC9584732 DOI: 10.1155/2022/3101486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 08/21/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction. Malnutrition is underdiagnosed in chronic obstructive pulmonary disease. Objectives. This study aimed to evaluate the nutritional status of COPD patients and the link between dyspnea and nutritional status. Methods. This longitudinal observational study included patients hospitalized with exacerbated COPD. Nutritional status was assessed using Nutrition Risk Screening 2002, anthropometric, and biochemical assessments, in the first 48 hours of hospitalization. Results. Thirty patients were evaluated. According to the Nutrition Risk Screening 2002, half of the patients were at increased risk of malnutrition. 36.7% were classified as malnourished if we only considered the body mass index. From the evaluation of the tricipital skin fold, 69.0% were classified as malnourished, with 48.3% having severe malnutrition. According to the serum albumin level, 29.6% had malnutrition criteria. A significant association between dyspnea and increasing age (
) was found. There was a strong association between the fold classification and the degrees of severity of dyspnea (Fisher exact test: 13.60,
, V Cramer = 0.826). Most patients were malnourished and had higher grades of dyspnea. Tricipital skinfold reflects subcutaneous adipose tissue; this anthropometric measurement seems to be a good method to classify the nutritional status of COPD patients. It classified the biggest portion of patients as malnourished. Conclusion. The number of patients classified as malnourished changed with the method under analysis. The tricipital skin fold parameter was strongly associated with the dyspnea score. Most patients had adipose tissue and muscular mass depletion.
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9
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Chen WZ, Zhang XZ, Zhang FM, Yu DY, Chen WH, Lin F, Dong QT, Zhuang CL, Yu Z. Coexistence of GLIM-defined malnutrition and sarcopenia have negative effect on the clinical outcomes in the elderly gastric cancer patients after radical gastrectomy. Front Nutr 2022; 9:960670. [PMID: 36061885 PMCID: PMC9437552 DOI: 10.3389/fnut.2022.960670] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 08/02/2022] [Indexed: 11/21/2022] Open
Abstract
Background Malnutrition and sarcopenia are common in elderly gastric cancer patients, which are also interrelated and affect each other. We aimed to determine the characteristics of coexistence of malnutrition and sarcopenia in the elderly gastric cancer patients and investigate the predictive roles of malnutrition and sarcopenia on clinical outcomes. Methods Between 2014 and 2019, a total of 742 elderly gastric cancer patients were enrolled. Malnutrition and sarcopenia were diagnosed according to the most recent diagnostic criteria. Patients were divided into four groups according to presence of these two symptoms. Clinical characteristics, short- and long-term outcomes were compared among four groups. The independent risk factors for complications and survival were evaluated using univariate and multivariate analyses. Results Of all patients, 34.8% were diagnosed with malnutrition and 34.0% were diagnosed with sarcopenia. Patients with both malnutrition and sarcopenia had the highest rate of total (P < 0.001), surgical (P = 0.003), and medical complications (P = 0.025), and the highest postoperative hospital stays (P < 0.001) and hospitalization costs (P < 0.001). They also had the worst overall survival (P < 0.0001) and disease-free survival (P < 0.0001). Sarcopenia and Charlson Comorbidity Index (≥2) were independent risk factors for total complications. Hypoalbuminemia and malnutrition were non-tumor-related independent risk factors for overall survival and disease-free survival. Conclusions Malnutrition and sarcopenia had superimposed negative effects on elderly gastric cancer patients. Preoperative geriatric evaluation including screening for malnutrition and sarcopenia are recommended for all elderly gastric cancer patients for accurate treatment strategy.
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Affiliation(s)
- Wei-Zhe Chen
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xian-Zhong Zhang
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Feng-Min Zhang
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ding-Ye Yu
- Department of General Surgery, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen-Hao Chen
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Feng Lin
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Qian-Tong Dong
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Cheng-Le Zhuang
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
- Cheng-Le Zhuang
| | - Zhen Yu
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
- *Correspondence: Zhen Yu
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10
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Kaluźniak-Szymanowska A, Krzymińska-Siemaszko R, Wieczorowska-Tobis K, Deskur-Śmielecka E. Optimal Assessment of Nutritional Status in Older Subjects with the Chronic Obstructive Pulmonary Disease-A Comparison of Three Screening Tools Used in the GLIM Diagnostic Algorithm. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031025. [PMID: 35162048 PMCID: PMC8834573 DOI: 10.3390/ijerph19031025] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/10/2022] [Accepted: 01/15/2022] [Indexed: 02/01/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is a recognized risk factor for malnutrition. The European Respiratory Society (ERS) statement included nutritional status assessment and dietary intervention as essential components of comprehensive management in subjects with COPD. According to the GLIM algorithm, the first step in diagnosing malnutrition is risk screening with a validated tool. Our study aimed to assess the diagnostic performance of three screening tools (MNA-SF, MUST, and NRS-2002) used in the GLIM algorithm in older patients with COPD. Additionally, we evaluated the agreement between these tools in the diagnostics of malnutrition. We performed a cross-sectional study of 124 patients aged at least 60 years with COPD diagnosed, based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD). We assessed the participants’ nutritional status with the three examined screening questionnaires (MNA-SF, MUST, and NRS-2002). Regardless of their results, we performed full malnutrition diagnostics following the GLIM algorithm in all subjects. The proportion of malnourished participants varied from 18.5% for the MUST questionnaire to 27.4% for the MNA-SF and 57.3% for the NRS-2002 score. Based on the GLIM criteria, malnutrition was diagnosed in 48 subjects (38.7%). All assessed questionnaires had an unsatisfactory sensitivity against the GLIM criteria for malnutrition: it was fair (58.3%) for the MNA-SF tool and poor for the MUST and NRS-2002 questionnaires (47.9% for both questionnaires). Considering the negative health consequences of malnutrition, a full diagnostic including GLIM etiologic and phenotypic criteria should be recommended in all elderly patients with COPD, regardless of the screening results.
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11
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Malnutrition, Sarcopenia, and Malnutrition-Sarcopenia Syndrome in Older Adults with COPD. Nutrients 2021; 14:nu14010044. [PMID: 35010919 PMCID: PMC8746722 DOI: 10.3390/nu14010044] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/15/2021] [Accepted: 12/21/2021] [Indexed: 12/23/2022] Open
Abstract
Purpose: 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.Patients and methods: 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. Results: 22.6% of participants had malnutrition according to the GLIM criteria. Subjects with malnutrition had lower gait speed (p = 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. Conclusions: 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.
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12
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de Bisschop C, Caron F, Ingrand P, Bretonneau Q, Dupuy O, Meurice JC. Does branched-chain amino acid supplementation improve pulmonary rehabilitation effect in COPD? Respir Med 2021; 189:106642. [PMID: 34678585 DOI: 10.1016/j.rmed.2021.106642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/03/2021] [Accepted: 10/05/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Muscle wasting is frequent in chronic obstructive lung disease (COPD) and associated with low branched-chain amino acids (BCAA). We hypothesized that BCAA supplementation could potentiate the effect of a pulmonary rehabilitation program (PRP) by inducing muscular change. MATERIALS AND METHODS Sixty COPD patients (GOLD 2-3) were involved in an ambulatory 4-week PRP either with BCAA oral daily supplementation or placebo daily supplementation in a randomized double-blind design. Maximal exercise test including quadriceps oxygenation measurements, functional exercise test, muscle strength, lung function tests, body composition, dyspnea and quality of life were assessed before and after PRP. RESULTS Fifty-four patients (64.9 ± 8.3 years) completed the protocol. In both groups, maximal exercise capacity, functional and muscle performances, quality of life and dyspnea were improved after 4-week PRP (p ≤ 0.01). Changes in muscle oxygenation during the maximal exercise and recovery period were not modified after 4-week PRP in BCAA group. Contrarily, in the placebo group the muscle oxygenation kinetic of recovery was slowed down after PRP. CONCLUSION This study demonstrated that a 4-week PRP with BCAA supplementation is not more beneficial than PRP alone for patients. A longer duration of supplementation or a more precise targeting of patients would need to be investigated to validate an effect on muscle recovery and to demonstrate other beneficial effects.
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Affiliation(s)
| | - Fabrice Caron
- CHU Poitiers, F-86000, Poitiers, France; Centre de Réadaptation Du Moulin Vert, F-86340, Nieuil L'espoir, France
| | - Pierre Ingrand
- Université de Poitiers, CHU Poitiers, INSERM CIC 1402, F-86000, Poitiers, France
| | | | - Olivier Dupuy
- Université de Poitiers, MOVE, F-86000, Poitiers, France
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13
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Harmon KK, Stout JR, Fukuda DH, Pabian PS, Rawson ES, Stock MS. The Application of Creatine Supplementation in Medical Rehabilitation. Nutrients 2021; 13:1825. [PMID: 34071875 PMCID: PMC8230227 DOI: 10.3390/nu13061825] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/17/2021] [Accepted: 05/26/2021] [Indexed: 02/07/2023] Open
Abstract
Numerous health conditions affecting the musculoskeletal, cardiopulmonary, and nervous systems can result in physical dysfunction, impaired performance, muscle weakness, and disuse-induced atrophy. Due to its well-documented anabolic potential, creatine monohydrate has been investigated as a supplemental agent to mitigate the loss of muscle mass and function in a variety of acute and chronic conditions. A review of the literature was conducted to assess the current state of knowledge regarding the effects of creatine supplementation on rehabilitation from immobilization and injury, neurodegenerative diseases, cardiopulmonary disease, and other muscular disorders. Several of the findings are encouraging, showcasing creatine's potential efficacy as a supplemental agent via preservation of muscle mass, strength, and physical function; however, the results are not consistent. For multiple diseases, only a few creatine studies with small sample sizes have been published, making it difficult to draw definitive conclusions. Rationale for discordant findings is further complicated by differences in disease pathologies, intervention protocols, creatine dosing and duration, and patient population. While creatine supplementation demonstrates promise as a therapeutic aid, more research is needed to fill gaps in knowledge within medical rehabilitation.
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Affiliation(s)
- Kylie K. Harmon
- Neuromuscular Plasticity Laboratory, Institute of Exercise Physiology and Rehabilitation Science, School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL 32816, USA;
| | - Jeffrey R. Stout
- Physiology of Work and Exercise Response (POWER) Laboratory, Institute of Exercise Physiology and Rehabilitation Science, School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL 32816, USA; (J.R.S.); (D.H.F.)
| | - David H. Fukuda
- Physiology of Work and Exercise Response (POWER) Laboratory, Institute of Exercise Physiology and Rehabilitation Science, School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL 32816, USA; (J.R.S.); (D.H.F.)
| | - Patrick S. Pabian
- Musculoskeletal Research Laboratory, Institute of Exercise Physiology and Rehabilitation Science, School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL 32816, USA;
| | - Eric S. Rawson
- Department of Health, Nutrition, and Exercise Science, Messiah University, Mechanicsburg, PA 17055, USA;
| | - Matt S. Stock
- Neuromuscular Plasticity Laboratory, Institute of Exercise Physiology and Rehabilitation Science, School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL 32816, USA;
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14
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Chelluboina B, Vemuganti R. Therapeutic potential of nutraceuticals to protect brain after stroke. Neurochem Int 2020; 142:104908. [PMID: 33220386 DOI: 10.1016/j.neuint.2020.104908] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/14/2020] [Accepted: 11/16/2020] [Indexed: 02/07/2023]
Abstract
Stroke leads to significant neuronal death and long-term neurological disability due to synergistic pathogenic mechanisms. Stroke induces a change in eating habits and in many cases, leads to undernutrition that aggravates the post-stroke pathology. Proper nutritional regimen remains a major strategy to control the modifiable risk factors for cardiovascular and cerebrovascular diseases including stroke. Studies indicate that nutraceuticals (isolated and concentrated form of high-potency natural bioactive substances present in dietary nutritional components) can act as prophylactic as well as adjuvant therapeutic agents to prevent stroke risk, to promote ischemic tolerance and to reduce post-stroke consequences. Nutraceuticals are also thought to regulate blood pressure, delay neurodegeneration and improve overall vascular health. Nutraceuticals potentially mediate these effects by their powerful antioxidant and anti-inflammatory properties. This review discusses the studies that have highlighted the translational potential of nutraceuticals as stroke therapies.
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Affiliation(s)
- Bharath Chelluboina
- Department of Neurological Surgery, University of Wisconsin, Madison, WI, USA
| | - Raghu Vemuganti
- Department of Neurological Surgery, University of Wisconsin, Madison, WI, USA; William S. Middleton Veterans Administration Hospital, Madison, WI, USA.
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15
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Gephine S, Le Rouzic O, Machuron F, Wallaert B, Chenivesse C, Saey D, Maltais F, Mucci P, Grosbois JM. Long-Term Effectiveness of a Home-Based Pulmonary Rehabilitation in Older People with Chronic Obstructive Pulmonary Disease: A Retrospective Study. Int J Chron Obstruct Pulmon Dis 2020; 15:2505-2514. [PMID: 33116467 PMCID: PMC7571583 DOI: 10.2147/copd.s268901] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/22/2020] [Indexed: 12/14/2022] Open
Abstract
Background Long-term effectiveness of pulmonary rehabilitation (PR) is still uncertain in older people with severe chronic obstructive pulmonary disease (COPD). The objective was to compare the effects of home-based PR in people with COPD above and below the age of 70 years. Methods In this retrospective study, 480 people with COPD were recruited and divided into those ≤70 (n=341) and those >70 years of age (n=139). All participants underwent an 8 weeks of home-based PR, consisting of a weekly supervised 90-minute home session. Six-minute stepper test (6MST), timed-up and go test (TUG), Hospital Anxiety and Depression Scale, and Visual Simplified Respiratory Questionnaire (VSRQ) were assessed at baseline (M0), at 2 (M2), 8 (M8), 14 (M14) months after baseline. Results The older group was described by fewer current smokers (p <0.001), more long-term oxygen therapy use (p = 0.024), higher prevalence of comorbidities (p<0.001), lower 6MST score and higher TUG score (p<0.001), compared to the younger group. Both groups improved every outcome at M2 compared to baseline. At M2, 88% of people ≤70 years of age and 79% of those above 70 were considered as responders in at least one evaluated parameter (p = 0.013). Both groups maintained the benefits at M14, except for the VSRQ score and the number of responders to this outcome in the older group. Conclusion Regardless of the age, personalized home-based PR was effective for people with COPD in the short term. Above 70 years, an ageing effect appeared on the long-term effectiveness of quality of life benefit.
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Affiliation(s)
- Sarah Gephine
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Lille F-59000, France.,Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada
| | - Olivier Le Rouzic
- CHU Lille, Service de Pneumologie et Immuno-Allergologie, Centre de Référence Constitutif des Maladies Pulmonaires Rares, Lille F-59000, France.,Univ. Lille, Lille F-59000, France
| | - François Machuron
- Department of Biostatistics, Univ. Lille, CHU Lille, EA 2694 - Santé Publique: Épidémiologie et Qualité des Soins, Lille F-59000, France
| | - Benoit Wallaert
- CHU Lille, Service de Pneumologie et Immuno-Allergologie, Centre de Référence Constitutif des Maladies Pulmonaires Rares, Lille F-59000, France
| | - Cécile Chenivesse
- CHU Lille, Service de Pneumologie et Immuno-Allergologie, Centre de Référence Constitutif des Maladies Pulmonaires Rares, Lille F-59000, France.,Univ. Lille, Lille F-59000, France
| | - Didier Saey
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada
| | - François Maltais
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada
| | - Patrick Mucci
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Lille F-59000, France
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16
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Xue M, Cai C, Guan L, Xu Y, Lin J, Zeng Y, Hu H, Chen R, Wang H, Zhou L, Sun B. Exploration of n-6 and n-3 Polyunsaturated Fatty Acids Metabolites Associated with Nutritional Levels in Patients with Severe Stable Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2020; 15:1633-1642. [PMID: 32764909 PMCID: PMC7360408 DOI: 10.2147/copd.s245617] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 04/30/2020] [Indexed: 12/12/2022] Open
Abstract
Background and Objective Severe chronic obstructive pulmonary disease (COPD) is the terminal stage of the disease characterized by declined lung function, malnutrition, and poor prognosis. Such patients cannot tolerate long-time sports rehabilitation owing to dyspnea and fail to achieve the desired therapeutic effect; therefore, increasing nutritional support will be an important strategy for them. The present study applied metabolomics technology to evaluate the correlation between serum concentrations of polyunsaturated fatty acid (PUFA) metabolites, nutritional status, and lung function in patients with COPD to provide a theoretical basis for accurate nutritional support. Materials and Methods We enrolled 82 patients with stable severe COPD in our hospital. The general characteristics including height, weight, and lung function were recorded. Metabolomics was used to detect the concentrations of serum metabolites of n-3 and n-6 at baseline and at 24 and 52 weeks after enrollment. The correlations between nutrition level and pulmonary function and clinical indicators were evaluated. Results The concentrations of n-3 and n-6 increased over time along with the progression of COPD. Body mass index (BMI) and percent of ideal body weight (IBW%) decreased with disease development, and BMI was found to be significantly correlated with FEV1% predicted and FEV1/FVC. Serum levels of n-6 metabolites such as linoleic acid (LA), γ-linoleic acid (GLA), and arachidonic acid (ARA) (all P < 0.01) and the n-3 metabolites such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (all P < 0.05) showed significant correlations with BMI and were closely correlated with FEV1% predicted and FEV1/FVC of lung function (all P< 0.05). Conclusion This study demonstrates that malnutrition in patients with severe COPD is progressive and is positively correlated with n-3 and n-6 polyunsaturated fatty acids and lung function.
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Affiliation(s)
- Mingshan Xue
- Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Chuanxu Cai
- Department of Laboratory Medicine, Shenzhen Institute of Respiratory Diseases, Shenzhen People's Hospital, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical Medical College of Jinan University, Shenzhen, People's Republic of China
| | - Lili Guan
- Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Yifan Xu
- Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Jinsheng Lin
- Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Yifeng Zeng
- Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Haisheng Hu
- Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Rongchang Chen
- Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Hongman Wang
- Department of Respiratory and Critical Care Medicine, The Fifth Affiliated Hospital of Zunyi Medical University Zhuhai, Zhuhai, People's Republic of China
| | - Luqian Zhou
- Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Baoqing Sun
- Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China
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17
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Thinuan P, Siviroj P, Lerttrakarnnon P, Lorga T. Prevalence and Potential Predictors of Frailty among Community-Dwelling Older Persons in Northern Thailand: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114077. [PMID: 32521642 PMCID: PMC7312471 DOI: 10.3390/ijerph17114077] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/04/2020] [Accepted: 06/04/2020] [Indexed: 12/22/2022]
Abstract
This study aimed to determine the prevalence and associated factors of frailty among Thai older persons. A cross-sectional study was conducted with a representative sample of 1806 older persons aged 60 years or older. Frailty was assessed by Fried’s frailty phenotypes, which consists of five criteria, namely, unintended weight loss, exhaustion, slow walking, weak handgrip and decreased physical activity. Older people who met 3 in 5, 1–2 in 5, and none of the criteria were considered frail, pre-frail and non-frail respectively. The prevalence was calculated and multinomial logistic regression was performed. Prevalence rates of frailty, pre-frailty and non-frailty were 13.9% (95% CI 9.9 to 18.8), 50.9% (95% CI 47.5 to 54.1) and 35.1% (95% CI 31.5 to 39.9), respectively. Increasing age, lower education, having no spouse, poorer health perception, increasing number of comorbidities, osteoarthritis and smaller mid-arm circumference increased the risk of frailty (p < 0.001). The prevalence of geriatric frailty syndrome in this study was much higher than that of developed countries but was lower than that of less developed countries. Factors associated with frailty reflect common characteristics of disadvantaged older persons in Thailand.
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Affiliation(s)
- Payom Thinuan
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Penprapa Siviroj
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
- Correspondence:
| | - Peerasak Lerttrakarnnon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Thaworn Lorga
- School of Nursing, Mae Fah Luang University, Chiang Rai 57100, Thailand;
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18
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Lima TRL, Almeida VP, Ferreira AS, Guimarães FS, Lopes AJ. Handgrip Strength and Pulmonary Disease in the Elderly: What is the Link? Aging Dis 2019; 10:1109-1129. [PMID: 31595206 PMCID: PMC6764733 DOI: 10.14336/ad.2018.1226] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 12/26/2018] [Indexed: 12/15/2022] Open
Abstract
Societies in developed countries are aging at an unprecedented rate. Considering that aging is the most significant risk factor for many chronic lung diseases (CLDs), understanding this process may facilitate the development of new interventionist approaches. Skeletal muscle dysfunction is a serious problem in older adults with CLDs, reducing their quality of life and survival. In this study, we reviewed the possible links between handgrip strength (HGS)—a simple, noninvasive, low-cost measure of muscle function—and CLDs in the elderly. Different mechanisms appear to be involved in this association, including systemic inflammation, chronic hypoxemia, physical inactivity, malnutrition, and corticosteroid use. Respiratory and peripheral myopathy, associated with muscle atrophy and a shift in muscle fiber type, also seem to be major etiological contributors to CLDs. Moreover, sarcopenic obesity, which occurs in older adults with CLDs, impairs common inflammatory pathways that can potentiate each other and further accelerate the functional decline of HGS. Our findings support the concept that the systemic effects of CLDs may be determined by HGS, and HGS is a relevant measurement that should be considered in the clinical assessment of the elderly with CLDs. These reasons make HGS a useful practical tool for indirectly evaluating functional status in the elderly. At present, early muscle reconditioning and optimal nutrition appear to be the most effective approaches to reduce the impact of CLDs and low muscle strength on the quality of life of these individuals. Nonetheless, larger in-depth studies are needed to evaluate the link between HGS and CLDs.
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Affiliation(s)
- Tatiana Rafaela Lemos Lima
- 1Rehabilitation Sciences Post-Graduate Program, Augusto Motta University Center (UNISUAM), Bonsucesso, 21041-010, Rio de Janeiro, Brazil
| | - Vívian Pinto Almeida
- 1Rehabilitation Sciences Post-Graduate Program, Augusto Motta University Center (UNISUAM), Bonsucesso, 21041-010, Rio de Janeiro, Brazil
| | - Arthur Sá Ferreira
- 1Rehabilitation Sciences Post-Graduate Program, Augusto Motta University Center (UNISUAM), Bonsucesso, 21041-010, Rio de Janeiro, Brazil
| | - Fernando Silva Guimarães
- 1Rehabilitation Sciences Post-Graduate Program, Augusto Motta University Center (UNISUAM), Bonsucesso, 21041-010, Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- 1Rehabilitation Sciences Post-Graduate Program, Augusto Motta University Center (UNISUAM), Bonsucesso, 21041-010, Rio de Janeiro, Brazil.,2Post-graduate Program in Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Vila Isabel, 20550-170, Rio de Janeiro, Brazil
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