Usefulness of nutrition screening tools for sarcopenia screening with chronic obstructive pulmonary disease in JAPAN

Abstract

Background: Age-related loss of muscle, sarcopenia is recognized as one of the complications of COPD. Japan is now aging more rapidly than anywhere else in the world. Purpose: We examined whether nutritional screening tools are useful for sarcopenia screening in patients with stable COPD. Method: 61 out patients (male / female: 57/4, average age: 73.7 ± 7.3 years old) who received treatment with COPD were studied. The body composition was evaluated by bioelectrical impedance analysis (BIA) method which then calculated the skeletal muscle index (SMI). Based on the diagnostic criteria of AWGS (Asian Working Group for Sarcopenia), sarcopenia was diagnosed. We also performed nutritional screening for 61 COPD patients by using 4 types of nutritional screening tools; MNA (Mini Nutritional Assessment), MNA-SF (Mini Nutritional Assessment-Short Form), MUST (Malnutrition Universal Screening Tool) and GNRI (Geriatric Nutritional Risk Index). We examined whether the screening tools were useful for sarcopenia screening. Results: Sarcopenia was confirmed in 19 of 61 (31.1%) patients. The sensitivity and specificity of the screening tools for 19 sarcopenia patients were 1.0 · 0.59, 0.84 · 0.52, 0.73 · 0.73, 0.68 · 0.73 (MNA, MNA-SF, MUST, GNRI). The AUC on ROC curves were created for 61 patients with COPD, the AUC was 0.875, 0.871, 0.727, 0.735 for MNA, MNA-SF, MUST and GNRI. Conclusions: Nutritional screening tools could be used for sarcopenia screening as well. Among the four screening tools, the MNA was the most sensitive and its AUC was the largest.