A Study on Evaluation of Nutritional Status in Patients with Chronic Obstructive Pulmonary Disease

BACKGROUND Currently, chronic obstructive pulmonary disease is the fourth leading cause of death in the world. Nutritional depletion is a common finding in patients with COPD (Chronic Obstructive Pulmonary Disease). Even stable COPD patients have high proportion of under nutrition. Malnutrition is an important factor that leads to low quality of life in COPD patients and could cause exacerbation of the disease. Hence malnutrition needs to be assessed and considered in management of COPD. METHODS A cross sectional study was conducted over a period of 2 years to determine the association of COPD with malnutrition. 50 male COPD patients between 40 to 60 years of age fulfilling the inclusion criteria were selected, and the analysis was restricted to this age group, so as to ensure the uniformity of analysis. They were staged based on PFT and evaluated by anthropometric measures and biochemical parameters. Statistical analysis was done and p < 0.05 was considered statistically significant. RESULTS In this study the average age of the population was 52.52 + 5.64 years. 50 male COPD patients were categorized into mild (n = 10), moderate (n = 27), severe (n = 10) and very severe (n = 3) groups with spirometry based on GOLD criteria. Anthropometric measures (BMI, TSF, MAMA, MAFA) and biochemical parameters (serum albumin and pre-albumin) were evaluated. The difference in severity of airway obstruction, body weight, BMI, pre-albumin and serum albumin among the various age groups was not significant statistically. There was a significant difference (p < 0.05) in BMI, MAMA, MAFA, pre-albumin and serum albumin values in severe and very severe airway obstruction patients when compared to those with mild and moderate airway obstruction. The present study showed a statistically significant and strong correlation of BMI (i.e. r = 0.75 and p < 0.05), MAMA (r = 0.81 and p < 0.05), MAFA (r = 0.72 and p < 0.05), serum pre-albumin (r = - 0.315 and p = 0.006), and albumin (r = 0.74) when compared with severity of airway obstruction. CONCLUSION A significant number of patients with Chronic Obstructive Pulmonary Disease was malnourished. Measures of protein stores (serum albumin and pre-albumin) and the anthropometric measures of nutrition [BMI, body muscle mass and fat stores] were inversely related with severity of airway obstruction.