Abstract
BackgroundMalnutrition and altered body composition are well-documented in chronic pulmonary diseases; however, investigation of nutritional status in interstitial lung disease (ILD) is limited. This study aimed to describe the nutritional status of ILD patients within three diagnostic groups and explore the relationship between nutritional status and quality of life (QoL).MethodsConsecutive patients attending an ILD clinic within a tertiary referral hospital in Sydney, Australia were studied. Weight, body-mass-index, anthropometrics, handgrip strength (HGS), subjective global assessment and QoL questionnaires (EQ-5D-5L and King’s-Brief Interstitial-Lung-Disease ‘K-BILD’) were collected. Associations between nutritional status and QoL were analysed.ResultsNinety participants were recruited and categorised: (1) Idiopathic Pulmonary Fibrosis (IPF) (2) Connective-Tissue Disease associated-ILD (CTD-ILD) or (3) Other (non-IPF/non-CTD ILD). Median age was 66.5 (18) years. Four-percent of patients were underweight and 50% were overweight or obese. Median HGS was 71%-(25.3) of predicted and was correlated to all measures of QoL including EQ-5D health-state index (r = 0.376, p < 0.0001), patient-reported EQ-5D-5L Visual Analogue Score (r = 0.367, p < 0.0001) and K-BILD total score (r = 0.346, p = 0.001). Twenty-three percent of the variance in K-BILD total score (F = 12.888, p < 0.0001) was explained by HGS (ß = 0.273, p = 0.006) and forced vital capacity % predicted (ß = 0.331, p = 0.001).ConclusionsAlthough a small number of ILD patients were malnourished, a large proportion of the cohort were overweight or obese. Handgrip strength was compromised and correlated to QoL. Future research with a larger cohort is required to explore the role of HGS as a predictor of QoL.
Highlights
Malnutrition and altered body composition are well-documented in chronic pulmonary diseases; investigation of nutritional status in interstitial lung disease (ILD) is limited
Malnutrition is well-documented in pulmonary diseases such as chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF) due to inadequate oral intake related to the prevalence of multiple symptoms such as anorexia and reflux, as well as increased metabolic requirements [11]
Most participants with Idiopathic pulmonary fibrosis (IPF) were treated with anti-fibrotic agents, while those with connective tissue disease (CTD)-ILD were often prescribed corticosteroids and immunosuppressant medication
Summary
Malnutrition and altered body composition are well-documented in chronic pulmonary diseases; investigation of nutritional status in interstitial lung disease (ILD) is limited. Patients often experience a range of disabling symptoms including dyspnoea and cough as well as non-respiratory symptoms such as depression, anxiety and fatigue and weight loss, all of which may contribute to the worse health related quality of life reported in ILD patients [8, 9]. Nutrition in chronic lung diseases is complex as both obesity as well as malnutrition exist [10]. Malnutrition is well-documented in pulmonary diseases such as chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF) due to inadequate oral intake related to the prevalence of multiple symptoms such as anorexia and reflux, as well as increased metabolic requirements [11]. Under nutrition is linked to poor clinical outcomes in CF patients [14]
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