Abstract
Background: Chronic obstructive pulmonary disease (COPD) is a disease with multiple systemic effects. Among them, weight loss and muscular wasting are responsible for low exercise capacity (1). Body composition is therefore important in the assessment of COPD patients, as well as exercise capacity and muscular strength.
Methods: The study was carried out at Pariyaram medical college hospital, Kannur, Kerala. 50 stable male COPD patients (cases), referred to Department of Pulmonary Medicine, outpatient clinic, for pulmonary rehabilitation, and 50 healthy male volunteers (controls), who were age matched, were studied.
Results: The mean weight, body mass index, mid upper arm circumference, calf circumference and hip circumference of the case group were found to be significantly lower than the control group. The waist circumference was also lower in the case group, whereas, the waist hip ratio was found to be higher than the control group.
Conclusion: Rehabilitation in COPD patients should be directed at maintaining a positive protein and energy balance by dietary counselling, supplementing essential amino acids, PUFAs, anabolic steroids along with exercise training.
Keywords: Body Composition, Copd, Fat Free Mass, Body Mass Index.
References
- Global strategy for the diagnosis, management and prevention of chronicobstructive pulmonary disease. GlobalInitiative for Chronic Obstructive Lung Disease. Available from http://www.
goldcopd.org. Updated: 2017.
- Schols AMWJ, Slangen J, Volovics L,et al. Weight loss is a reversible factor in the prognosis of chronic obstructive pulmonary disease. Am J Respir CritCare Med 1998; 157:1791-7
- Celli BR, Cote CG, Marin JM, et al.– The body-mass index, airflowobstruction, dyspnea, and exercisecapacity index in chronic obstructivepulmonary disease. N Engl J Med 2004; 350:1005-12
- Engelen MP, Schols AM, Does JD, etal. – Skeletal muscle weakness is associated with wasting of extremityfat-free mass but not with airflow obstruction in patients with chronic obstructive pulmonary disease. Am J Clin Nutr 2000; 71:733-8
- Schols AM, Mostert R, Soeters PB, etal. – Body composition and exercise performance in patients with chronic obstructive pulmonary disease. Thorax 1991; 46:695-9
- Baarends EM, Schols AM, Mostert R,et al. – Peak exercise response inrelation to tissue depletion in patientswith chronic obstructive pulmonarydisease. Eur Respir J 1997; 10:2807-13
- Sabino PG, Silva BM, Brunetto AF– Nutritional status is related to fat-freemass, exercise capacity and inspiratorystrength in severe chronic obstructivepulmonary disease patients. Clinics (SaoPaulo) 2010; 65:599-605
- Mostert R, Goris A, Weling-ScheepersC, et al. – Tissue depletion and health related quality of life in patients with chronic obstructive pulmonary disease.Respir Med 2000; 94:859-867
- Budweiser S, Meyer K, Jörres RA, etal. – Nutritional depletion and itsrelationship to respiratory impairment in patients with chronic respiratoryfailure due to COPD or restrictive thoracic diseases. Eur J Clin Nutr 2008;62:436-43
- von Haehling S, Anker SD – Cachexia as a major underestimated and unmetmedical need: facts and numbers. JCachexia Sarcopenia Muscle. 2010; 1:1-5
- Vermeeren MAP, Creutzberg EC,Schols AMWJ, et al. – Prevalence of nutritional depletion in a large out-patient population of patients withCOPD. Respir Med 2006; 100:1349-55
- Ischaki E, Papatheodorou G, Gaki E, etal. – Bodymass and fat-free mass indices in COPD: relation with variables expressing disease severity.Chest 2007; 132:164-9
- Vestbo J, Prescott E, Almdal T, Dahl M, Nordestgaard BG, Andersen T, Sørensen TI, Lange P, Am J Respir Crit Care Med, 173 (2006) 79 Respir. Crit. Care Med. 153 (1996) 961–966.
- Roxana G Galesanu,Sarah Bernard, Francois Maltais , obesity and chronic obstructive pulmonary disease: Is fatter really better? Can Respir J. sept-oct; 21(5):297-301 (2014)
- C. Creutzberg, A.M. Schols, F.C. Bothmer-Quaedvlieg, E.F.Wouters, Prevalence of an elevated resting energy expenditure inpatients with chronic obstructive pulmonary disease in relationto body composition and lung function, Eur. J. Clin. Nutr. 52(199
- Gray-Donald, L. Gibbons, S.H. Shapiro, et al, Nutritional status and mortality in chronic obstructive pulmonary disease,Am. J. Respir. Crit. Care Med. 153 (1996) 961–966.
- G. Agustı´, J. Sauleda, C. Miralles, et al, Skeletal muscleapoptosis and weight loss in chronic obstructive pulmonary disease, Am. J. Respir. Crit. Care Med. 166 (2002) 485–489 8) 396–401
- Schols AMWJ, Slangen J, Volovics L,et al. Weight loss is a reversible factorin the prognosis of chronic obstructivepulmonary disease. Am J Respir CritCare Med 1998; 157:1791-7
- Chen Y, Rennie D, Cormier Yf,Dosman J, Am J Clin Nutr, 85 (2007) 35
- Hopkinson Ns, Tennant Rc, Dayer Mj, Swallow Eb, HanselTT, Moxham J, Polkey MI, Respir Res, 8 (2007) 25.
- Sabino Pg, Silva Bm, Brunetto Af, Clinics (Sao Paulo), 65 (2010)599.
- Tungdim Mg, Kapoor S, Coll Antropol, 33 (2009) 1033.
- Buffar, Floris Gu, Putzu Pf, Marini E, Coll Antropol, 35 (2011)259.62:436-43
- Nordenson, A.M. Gro¨ nberg, L. Hulthe´n, et al, A validateddisease specific prediction equation for resting metabolic rate in underweight patients with COPD, Int. J. Chronic Obstructive Pulm. Dis. 5 (2010) 271–276
- Barreiro E, Gea J. Respiratory and limb muscle dysfunction in COPD. COPD 2015; 12:413-426
- Shu- Chuan Ho, Min- Fang Hsu, Han- Pin Kuo, Jiun- Yi Wang ,Li- Fei Chen, Kang- Yun Lee and Hsiao - Chi Chuang. The relationship between anthropometric indicators and walking distance in patients with COPD Int J Chron Obstruct Pulmon Dis. 2015; 1857-1862.
Corresponding Author
Dr Ramesan .K
Assistant Professor, Department of Medicine, Pariyaram Medical College
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v5i11.28
