Body composition in patients with chronic obstructive pulmonary disease: which method to use in clinical practice?
Body composition in patients with chronic obstructive pulmonary disease: which method to use in clinical practice?
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DOI：
10.1079/bjn20061798
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发表时间：
2006-07-01
影响因子：
3.6
通讯作者：
Jardim, J. R.
中科院分区：
文献类型：
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作者：
Lerario, M. C.;Sachs, A.;Jardim, J. R.
本研究的目的是比较人体测量与生物电阻抗（BIA）的密度测定法（双能X线吸收法; DEXA）的营养评估和身体组成的方法在门诊慢性阻塞性肺疾病（COPD）患者。我们对61例COPD患者（42例男性和19例女性）进行了一项横断面临床研究，患者平均年龄为66中心点5（sd 7中心点9）岁，1秒用力呼气量为1中心点3（sd 0中心点6）升（52中心点2（sd 19中心点8）%预测值），转诊至肺康复中心。通过人体测量、BIA和DEXA对患者的营养状况和身体成分进行评估。结果：轻度梗阻34个，占4%;中度梗阻31个，占2%;重度梗阻34个，占4%。根据BMI（平均24中心点5（sd 4中心点5）kg/m2），45中心点9%的患者体重正常，27中心点9%体重不足，26中心点2%肥胖。与DEXA相比，人体测量法和BIA与FFM相关性高（r 0中心点96和0中心点95; P < 0中心点001），可靠性高（α 0中心点98; P < 0中心点001）。两种方法之间的一致性分析表明，与DEXA相比，人体测量学高估了（0中心点62（差值2中心点89的标准差）kg），而BIA低估了FFM（0中心点61（差值2中心点82的标准差）kg）。我们的结论是，根据营养诊断，我们的COPD患者中有一半体重正常，而另一半则由同等比例的肥胖和体重不足患者组成。BIA和人体测量法估计的身体成分具有良好的可靠性和相关性与DEXA的三种方法提出了令人满意的临床准确性，尽管协议的限制有很大的差距。
The objective of the present study was to compare anthropometry with bioelectrical impedance (BIA) in relation to densitometry (dual-energy X-ray absorptiometry; DEXA) as methods of nutritional assessment and body composition in out-patients with chronic pulmonary obstructive disease (COPD). We conducted a cross-sectional clinical study with sixty-one patients with COPD (forty-two men and nineteen women), mean age of 66 center dot 5 (sd 7 center dot 9) years and forced expiratory volume in 1 s of 1 center dot 3 (sd 0 center dot 6) litres (52 center dot 2 (sd 19 center dot 8) % predicted), referred to the Pulmonary Rehabilitation Center. The patients were evaluated regarding nutrition status and body composition as determined by anthropometry, BIA and DEXA. In the results, 34 center dot 4 % showed mild obstruction, 31 center dot 2 %, moderate and 34 center dot 4 %, severe obstruction. According to the BMI (mean 24 center dot 5 (sd 4 center dot 5) kg/m(2)), 45 center dot 9 % of the patients exhibited normal weight, while 27 center dot 9 % were underweight and 26 center dot 2 % were obese. Related to fat-free mass (FFM), anthropometry and BIA compared with DEXA presented high correlations (r 0 center dot 96 and 0 center dot 95 respectively; P < 0 center dot 001) and high reliability between the methods (alpha 0 center dot 98; P < 0 center dot 001). Agreement analysis between the methods shows that anthropometry overestimates (0 center dot 62 (sd of the difference 2 center dot 89) kg) while BIA underestimates FFM (0 center dot 61 (sd of the difference 2 center dot 82) kg) compared with DEXA. We concluded that according to the nutritional diagnosis, half of our population of patients with COPD showed normal weight, while the other half comprised equal parts obese and underweight patients. Body composition estimated by BIA and anthropometry presented good reliability and correlation with DEXA; the three methods presented satisfactory clinical accuracy despite the great disparity of the limits of agreement.