Hyperammonaemia in patients with chronic obstructive pulmonary disease and obesity: association mechanisms, detection rate and correction

Abstract

To identify the frequency of hyperammonemia in patients with COPD and obesity, to analyze the degree of its influence on the COPD course and the quality of patients life, to assess the possibility of hyperammonemia correction with L-ornithine L-aspartate (LOLA). The study included 50 patients with non-acute COPD (GOLD 2), Group D, phenotype with frequent exacerbations, central-type obesity. At the 1st stage of the investigation, COPD course was evaluated, specific evaluation tests (mMRC, CCQ, CAT, SGRQ, SF-36) were used, the biochemical blood test was performed, hyperammoniemia was detected on a Pocket Chem BA PA-4140, and Number Connecting Test was performed. In the 2ndstage of the investigation, all patients were prescribed a course of treatment with LOLA and after 4 weeks the estimated parameters were compared in dynamics. After 4 weeks, comparative analysis showed reliable positive dynamics of subjective assessment of weakness, 2 scales of SGRQ questionnaire, all scales of SF-36 questionnaire, as well as reliable reduction of ammonia level by 18.26 mol/l, normal value of Number Connecting Test. Detection of hyperammoniemia in patients with COPD and obesity and its correction with LOLA seems rational in order to reduce toxic effects of ammonia on organs and systems in this category of patients.