Exploration of n-6 and n-3 Polyunsaturated Fatty Acids Metabolites Associated with Nutritional Levels in Patients with Severe Stable Chronic Obstructive Pulmonary Disease
Exploration of n-6 and n-3 Polyunsaturated Fatty Acids Metabolites Associated with Nutritional Levels in Patients with Severe Stable Chronic Obstructive Pulmonary Disease
复制标题
探索与严重稳定慢性阻塞性肺病患者营养水平相关的 n-6 和 n-3 多不饱和脂肪酸代谢物
DOI：
10.2147/copd.s245617
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发表时间：
2020-01-01
影响因子：
2.8
通讯作者：
Sun，Baoqing
中科院分区：
文献类型：
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作者：
Xue，Mingshan;Cai，Chuanxu;Sun，Baoqing
背景与目的重度慢性阻塞性肺疾病（COPD）是以肺功能下降、营养不良、预后不良为特征的疾病终末期。这类患者由于呼吸困难而不能耐受长时间的运动康复，达不到预期的治疗效果，因此，增加营养支持将是其重要策略。本研究应用代谢组学技术评价COPD患者血清多不饱和脂肪酸（PUFA）代谢产物浓度与营养状况及肺功能的相关性，为准确的营养支持提供理论依据。材料与方法收集我院收治的82例稳定期重度COPD患者。记录一般特征，包括身高、体重和肺功能。采用代谢组学方法检测入组前、入组后24周和52周n-3和n-6的血清代谢物浓度。评价营养水平与肺功能及临床指标的相关性。结果n-3、n-6浓度随着COPD的加重而沿着升高。体重指数（BMI）和理想体重百分比（IBW%）随病情进展而降低，BMI与FEV 1占预计值的百分比和FEV 1/FVC显著相关。血清中n-6代谢产物如亚油酸（LA）、γ-亚油酸（GLA）、花生四烯酸（ARA）（均P < 0.01）和n-3代谢产物二十碳五烯酸（EPA）、二十二碳六烯酸（DHA）（均P < 0.05）与BMI呈显著相关，并与FEV 1%预测值和肺功能FEV 1/FVC密切相关（均P< 0.05）。结论重度COPD患者营养不良呈进行性发展，营养不良与n-3、n-6多不饱和脂肪酸及肺功能呈正相关。
Background and Objective Severe chronic obstructive pulmonary disease (COPD) is the terminal stage of the disease characterized by declined lung function, malnutrition, and poor prognosis. Such patients cannot tolerate long-time sports rehabilitation owing to dyspnea and fail to achieve the desired therapeutic effect; therefore, increasing nutritional support will be an important strategy for them. The present study applied metabolomics technology to evaluate the correlation between serum concentrations of polyunsaturated fatty acid (PUFA) metabolites, nutritional status, and lung function in patients with COPD to provide a theoretical basis for accurate nutritional support. Materials and Methods We enrolled 82 patients with stable severe COPD in our hospital. The general characteristics including height, weight, and lung function were recorded. Metabolomics was used to detect the concentrations of serum metabolites of n-3 and n-6 at baseline and at 24 and 52 weeks after enrollment. The correlations between nutrition level and pulmonary function and clinical indicators were evaluated. Results The concentrations of n-3 and n-6 increased over time along with the progression of COPD. Body mass index (BMI) and percent of ideal body weight (IBW%) decreased with disease development, and BMI was found to be significantly correlated with FEV1% predicted and FEV1/FVC. Serum levels of n-6 metabolites such as linoleic acid (LA), γ-linoleic acid (GLA), and arachidonic acid (ARA) (all P < 0.01) and the n-3 metabolites such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (all P < 0.05) showed significant correlations with BMI and were closely correlated with FEV1% predicted and FEV1/FVC of lung function (all P< 0.05). Conclusion This study demonstrates that malnutrition in patients with severe COPD is progressive and is positively correlated with n-3 and n-6 polyunsaturated fatty acids and lung function.