Nutritional status in patients with Chronic Obstructive Pulmonary Disease: relationship between muscle strength and body composition

Abstract

Chronic obstructive pulmonary disease (COPD) is a complex syndrome and an important public health challenge. Although defined as a chronic inflammatory respiratory disease, COPD is heterogeneous, being characterized by a number of systemic consequences and co-morbidities, which contribute to disease severity. Specifically, nutritional disorders (i.e. malnutrition) and nutritionrelated conditions (i.e. muscle dysfunction) are highly prevalent extra pulmonary manifestations of COPD, associated with important consequences for risk assessment stratification and management of the disease. General aim of this thesis was to investigate the occurrence of alterations of body composition and its relationship with muscle strength. More specifically, five studies on COPD patients had been carried out in order to systematically review the use of bioelectrical impedance analysis (BIA) for the assessment of body composition; to evaluate the prevalence of malnutrition and sarcopenia and their relationship with functional parameters; to compare BIA variables between COPD patients and controls and to study the association of muscle strength with body composition estimates and BIA variables. As a final point, this thesis aimed to explore the amount of visceral adipose tissue located in the abdominal region using dual-energy x-ray absorptiometry and to determine its relation with respiratory parameters and other indices of body composition. In conclusion, this thesis provides a detailed overview of the assessment of nutritional status and body composition in COPD patients, especially in relation with respiratory function and muscle strength, bringing to light the need for prevention strategies and suggesting possible tools for the implementation of personalized approaches for COPD patients.