A cross sectional study to assess the nutritional status of Chronic Obstructive Pulmonary Disease Patients

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable disease, is a major public health concern. Therefore, the present study was conducted to assess the nutritional status in COPD patients by using anthropometric, biochemical and bioelectric impedance analysis. Methods: This cross-sectional study conducted in the Department of Pulmonary Medicine, Medical College, Thiruvananthapuram, India from March 2013 to November 2014. A pulmonary specialist diagnosed all subjects. Using revised GOLD 2011 criteria they were divided into four groups (A, B, C, D). Anthropometric and biochemical indices, body composition analyses by bioelectric impedance, spirometry test, and determination of disease severity were performed in all subjects. Results: A total of 435 COPD patients included 287 men (60.0%) and 148 women (34.0%), with a mean age of 60.2 (SD11.2) yr in disease stages A to D. Of all COPD patients, BMI was less than 18.5 kg/m2 for 37.9%. This Prevalence of under nutrition based on BMI was found to be statistically significant among study participants with p<0.001. Mean value of BMI, MAC, MAMC and TSF significantly lowered as the severity of COPD increased with p <0.001. Decreased mean values of FM, FMI, and FFM were significantly associated with increasing severity of COPD with p <0.001. Plasma albumin was less than 3.5 g/l among 72 (17%) patients. Total protein, less than 6 g/l was founded in 58 (13%) of patients. Plasma levels of albumin, total protein, urea, creatinine were lowered with the increase in the severity of disease. Conclusion: The study findings highlight the importance to consider body composition in addition to body mass index as the only criterion of malnutrition, because patients do show frequent alterations in body composition, affecting the muscle store, the fat and total body water as the disease became more severe.