Breaking News
December 12, 2018 - Sacrificial immune cells alert body to infection
December 12, 2018 - Low-salt diet may be more beneficial for females than males
December 12, 2018 - Major soil organic matter compound battles chronic wasting disease
December 12, 2018 - Findings may open up new ways to treat dwarfism and other ER-stress-related conditions
December 12, 2018 - New computational model provides clearer picture of shape-changing cells’ structure and mechanics
December 12, 2018 - 10 Facts on Patient Safety
December 12, 2018 - Poorest dying nearly 10 years younger than the rich in ‘deeply worrying’ trend for UK
December 12, 2018 - Innovative care model for children with ASD reduces use of behavioral drugs in ED
December 12, 2018 - Spending time in and around Hong Kong’s waters linked to better health and wellbeing
December 12, 2018 - Simple measures to prevent weight gain over Christmas
December 12, 2018 - Research advances offer hope for patient-tailored AML treatment
December 12, 2018 - Researchers discover a ‘blind spot’ in atomic force microscopy
December 12, 2018 - Sprayable gel could help prevent recurrences of cancer after surgery
December 12, 2018 - SLU researchers explore how fetal exposure to inflammation can alter immunity in newborns
December 12, 2018 - How do patients want to discuss symptoms with clinicians?
December 12, 2018 - Zinc chelation may be able to deliver drug to insulin-producing cells
December 12, 2018 - Brigham researchers develop automated, low-cost tool to predict a woman’s ovulation
December 12, 2018 - Some people with Type 2 diabetes may be testing their blood sugar more often than needed
December 12, 2018 - Slow-growing type of glioma may be vulnerable to immunotherapy, suggests study
December 12, 2018 - Study provides new information regarding microRNA function in cellular homeostasis of zebrafish
December 12, 2018 - Study provides new understanding of mysterious ‘hereditary swelling’
December 12, 2018 - Researchers shed new light on how to combat Shiga and ricin toxins
December 12, 2018 - Pregnant Women Commonly Refuse Vaccines
December 12, 2018 - Drug treatment could offer new hope for some patients with brain bleeding
December 12, 2018 - Health care financial burden of animal-related injuries is growing, study says
December 12, 2018 - Macrophage cells could help repair the heart following a heart attack, study finds
December 12, 2018 - Researchers develop new system for efficiently producing human norovirus
December 12, 2018 - New artificial intelligence-based system to differentiate between different types of cancer cells
December 11, 2018 - Brazilian professors propose guidelines for therapeutic use of melatonin
December 11, 2018 - Healthy Lifestyle Lowers Odds of Breast Cancer’s Return
December 11, 2018 - New research identifies two genes linked to serious congenital heart condition
December 11, 2018 - NIH Director talks science, STEM careers with preteens
December 11, 2018 - Disabling a Cellular Antivirus System Could Improve Gene Therapy
December 11, 2018 - New tool swiftly provides accurate measure of patients’ cognitive difficulties
December 11, 2018 - NICE releases new guidelines for diagnosis and management of COPD
December 11, 2018 - Without Obamacare penalty, think it’ll be nice to drop your plan? Better think twice
December 11, 2018 - Researchers capture high-resolution X-ray and NMR image of key immune regulator
December 11, 2018 - Natural flavonoid is effective at treating leishmanisis infections, study shows
December 11, 2018 - Avoidant grievers unconsciously monitor and block mind-wandering contents, study shows
December 11, 2018 - Study identifies how hantaviruses infect lung cells
December 11, 2018 - Improving PTSD care through genetics
December 11, 2018 - Dermatology providers show interest in recommending cannabinoids to patients
December 11, 2018 - Researchers to study effects of electroconvulsive therapy on Alzheimer’s patients with aggression
December 11, 2018 - Four dried fruits have lower glycemic index than starchy foods, study finds
December 11, 2018 - Optimization of drug dose sizes can reduce pharmaceutical wastage
December 11, 2018 - Ultrarestrictive opioid prescribing strategy linked with reduction in number of pills dispensed
December 11, 2018 - PET scans to optimize tuberculosis meningitis treatments and personalize care, study finds
December 11, 2018 - Researchers aim to identify and target high blood pressure indicators
December 11, 2018 - Researchers identify immune cell subset that may drive chronic inflammation
December 11, 2018 - Ezogabine treatment reduces motor neuron excitability in ALS patients, study shows
December 11, 2018 - One implant, two prices. It depends on who’s paying.
December 11, 2018 - Standardizing feeding practices improves growth trends for micro-preemies
December 11, 2018 - COPD Tied to Obesity in Male, Female Never-Smokers
December 11, 2018 - Flossing: Information for Caregivers
December 11, 2018 - Does breastfeeding hormone protect against type 2 diabetes?
December 11, 2018 - Educating future doctors to prescribe physical activity for their patients
December 11, 2018 - Krystal 2000 microplate design improves fluorescence and luminescence measurement
December 11, 2018 - FDA clears mobile medical app to help increase retention in recovery program for opioid use disorder
December 11, 2018 - Overcoming Challenges in High-Speed Centrifugation Experiments
December 11, 2018 - Study shows link between neighborhoods’ socioeconomic status and dietary choices
December 11, 2018 - Lower BMI before obesity surgery predicts greater post-operative weight loss, study finds
December 11, 2018 - Obesity May Be Driving Rise in Uterine Cancers
December 11, 2018 - Antioxidants may prevent cognitive impairment in diabetes
December 11, 2018 - Study discovers link between meditation and how individuals respond to feedback
December 11, 2018 - Researchers identify potential diagnostic tool for Alzheimer’s disease
December 11, 2018 - Oral cancer prognostic signature identified
December 11, 2018 - How Can I Find Out What Caused My Miscarriage?
December 11, 2018 - Novel personalized medicine tool for assessing inherited colorectal cancer syndrome risk developed
December 11, 2018 - Study uncovers 11 new genes associated with epilepsy
December 11, 2018 - Filling research gaps could help develop more disability-inclusive workplaces
December 11, 2018 - Cartilage tissue engineering brings good news for patients with cartilage defects
December 11, 2018 - Novel 3D printing workflow helps predict leaky heart valves
December 11, 2018 - Imagination can help overcome fear and anxiety-related disorders, shows study
December 11, 2018 - Are caries linked to political regime?
December 11, 2018 - Leader in Diabetes Clinical Trials Wins Naomi Berrie Award
December 11, 2018 - Scientists discover cellular mechanism that triggers pneumonia in humans
December 11, 2018 - Increasing mental health problems related to drug use in over 55’s
December 11, 2018 - High-intensity interval exercise could help combat cognitive dysfunction in obese people
December 11, 2018 - Annual flu shot can save lives of heart failure patients
December 11, 2018 - Researchers compare health outcomes for VA and non-VA hospitals
Malnutrition, Sarcopenia Common in Advanced COPD

Malnutrition, Sarcopenia Common in Advanced COPD

image_pdfDownload PDFimage_print

Action Points

  • About one-fifth of patients with chronic obstructive pulmonary disease (COPD) in a newly reported study suffered from disease-related malnutrition.
  • Note that the prevalence of sarcopenia was significantly higher in patients with malnutrition, especially in those with cachexia.

About one-fifth of patients with chronic obstructive pulmonary disease (COPD) in a newly reported study suffered from disease-related malnutrition, based on international diagnostic criteria, and half of patients with advanced disease were malnourished.

The cross-sectional analysis also showed a high rate of skeletal muscle mass loss in COPD patients based on international standard criteria.

The study, appearing in the journal Respiratory Medicine, is the first to provide data on the prevalence of malnutrition and sarcopenia among COPD patients using newly established criteria from the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Working Group on Sarcopenia in Older People (EWGSOP).

“A relatively high prevalence of malnutrition and sarcopenia was found in COPD patients applying international standard criteria, with some discrepancy between the two diagnoses,” Francesca de Blasio, PhD, of Italy’s University of Naples Medical School, and colleagues, wrote. “In addition, clear-cut changes in raw bioimpedance analysis (BIA) variables were observed in malnourished patients with systemic inflammation and sarcopenia patients.”

Weight loss, poor nutrition, and sarcopenia are common disease-related features of advanced COPD which have important implications for the management of disease, but defining the diagnostic criteria for malnutrition or sarcopenia is widely debated, the researchers noted.

“A wide range of differences in the estimated prevalence of malnutrition in COPD has been reported in the literature, possibly due not only to the characteristics of patients (stages of the disease, exacerbations, etc.), but also to the use of different diagnostic approaches,” they wrote.

The researchers noted that in the clinical setting, fat-free mass (FEM) and skeletal muscle mass (SM) are commonly estimated in COPD patients using predictive equations that include bioimpedance analysis data. One objective of their study was to assess whether significant changes in raw BIA variables occur in the context of COPD-related malnutrition and/or sarcopenia.

The cross-sectional study included 263 patients with COPD (185 males and 78 females) who underwent both clinical examination and respiratory, anthropometric, bio-electrical impedance analysis (BIA raw variables: phase angle and impedance ratio), handgrip strength (HGS), 4-m gait speed and biochemical measurements while undergoing a comprehensive, inpatient 4-to-6 week pulmonary rehabilitation protocol.

Malnutrition and sarcopenia were diagnosed based on ESPEN and EWGSOP criteria, respectively.

All patients were 50 or older and had a baseline post-bronchodilator ratio of FEV1 to forced vital capacity of less than 0.7.

Among the main study findings:

  • Overall prevalence of malnutrition and sarcopenia was 19.8% and 24.0%, respectively, and increasing with disease severity
  • Prevalence of sarcopenia was significantly higher in patients with malnutrition (71.2% versus 12.3%; P<0.001), especially in those with cachexia (85.7% versus 61.3%; P<0.001)
  • Malnourished patients with sarcopenia had a significant reduction in BMI, fat-free mass and HGS compared to non-sarcopenic patients
  • Impedance ratio significantly increased and phase angle decreased in patients with severe sarcopenia and in cachectic patients

“Raw BIA variables (IR and phase angle) are altered in malnourished COPD patients, especially in those with cachexia (i.e., disease-related malnutrition with inflammation) or severe sarcopenia,” the researchers wrote. “BIA is a quick, non-invasive method to estimate body composition in the clinical setting, with the purpose to identify malnutrition and improve treatment (i.e., nutritional support and/or exercise rehabilitation).”

Lack of data on FFM or SM obtained with dual-energy x-ray absorptiometry (DXA) or other reference techniques was an important limitation, the researchers noted.

“Defining nutritional depletion and malnutrition should be of primary importance in both the clinical setting and management of COPD patients,” de Blasio and colleagues concluded.

“According to the results of the present study, there is a need for standardized and reproducible criteria in the diagnosis of malnutrition and sarcopenia in COPD. Within the group of malnourished patients, very clear differences emerged between patients with and without systemic inflammation with respect to raw BIA variables, i.e., IR and [phase angle]. Further research should further assess the applications of BIA for both clinical assessment of malnutrition and sarcopenia and the evaluation of the response to nutritional and/or pharmacological interventions.”

The researchers declared no relevant relationships with industry related to this study.

  • Reviewed by
    Robert Jasmer, MD Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner

1969-12-31T19:00:00-0500

last updated

Tagged with:

About author

Related Articles