Body mass and fat-free mass indices in COPD - Relation with variables expressing disease severity
Body mass and fat-free mass indices in COPD - Relation with variables expressing disease severity
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DOI：
10.1378/chest.06-2789
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发表时间：
2007-07-01
期刊：
影响因子：
9.6
通讯作者：
Loukides, Stelios
中科院分区：
文献类型：
--
作者：
Ischaki, Eleni;Papatheodorou, Georgios;Loukides, Stelios
背景：慢性阻塞性肺病主要影响肺部，但也会产生系统性后果，根据全球慢性阻塞性肺病倡议（GOLD）指南，最近的分期并未反映出这些后果。身体质量指数（BMI）和无脂质量指数（FFMI）代表慢性阻塞性肺病营养异常的不同方面。我们研究BMI和FFMI是否与表达气流阻塞和限制、运动能力、气道炎症和生活质量的参数有关，以及它们是否反映疾病的GOLD分期。方法:将100例临床稳定型慢阻肺患者平均分为5个阶段，对其进行BMI、FFMI（通过生物电阻抗分析测量）、气道阻塞和过度充气（FEV1、FEV1/FVC、吸气量）、运动能力（6分钟步行距离[6MWD]、6MWD前后的Borg量表）、慢性呼吸困难（医学研究委员会（MRC）量表）、气道炎症（痰鉴别细胞计数、白三ene B、上清）、和生活质量（慢性呼吸疾病问卷的情感部分）。结果：6MWD与BMI、FFMI值均显著相关，FFMI与MRC量表、FEV1预测百分比、FEV1/FVC比值显著相关。两种营养指标之间没有相关性。COPD 5期患者的BMI无统计学差异，FFMI反映了疾病的分期，在0期达到最高值。结论：营养状况主要与运动能力有关。与BMI相比，FFMI似乎在表达疾病严重程度变量以及当前分期方面更准确。
Background: COPD primarily affects the lungs but also produces systemic consequences that are not reflected by the recent staging according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. Body mass index (BMI) and fat-free mass index (FFMI) represent different aspects of nutrition abnormalities in COPD. We investigated whether BMI and FFMI could be related to parameters expressing airflow obstruction and limitation, exercise capacity, airway inflammation, and quality of life, and whether they would reflect the GOLD staging of the disease.Methods: One hundred patients with clinically stable COPD equally classified into the five stages of the disease were evaluated for BMI, FFMI (measured by bioelectrical impedance analysis), airway obstruction and hyperinflation (FEV1, FEV1/FVC, inspiratory capacity), exercise capacity (6-min walk distance [6MWD], Borg scale before and after 6MWD]), chronic dyspnea using the Medical Research Council (MRC) scale, airway inflammation (sputum differential cell counts, leukotriene B, in supernatant), and quality of life (emotional part of the chronic respiratory disease questionnaire).Results: 6MWD was significantly associated with both BMI and FFMI values, while FFMI additionally presented significant correlations with MRC scale, percentage of predicted FEV1 and FEV1/FVC ratio. No association was observed between the two nutritional indexes. BMI was not statistically different among patients in the five stages of COPD, while FFMI reflected the staging of the disease, presenting the highest values in stage 0.Conclusions: Nutritional status is mainly related to exercise capacity. FFMI seems to be more accurate in expressing variables of disease severity, as well as the current staging compared to BMI.