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Relation between physical capacity, nutritional status and systemic inflammation in COPD
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
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2011 (English)In: Clinical Respiratory Journal, ISSN 1752-6981, E-ISSN 1752-699X, Vol. 5, no 3, 136-142 p.Article in journal (Refereed) Published
Abstract [en]

Background: Decreased physical capacity, weight loss, fat-free mass depletion and systemic inflammation are frequently observed in patients with chronic obstructive pulmonary disease (COPD).

Objective: Our aim was to examine relations between physical capacity, nutritional status, systemic inflammation and disease severity in COPD.

Method: Forty nine patients with moderate to severe COPD were included in the study. Spirometry was preformed. Physical capacity was determined by a progressive symptom limited cycle ergo meter test, incremental shuttle walking test, 12-minute walk distance and hand grip strength test. Nutritional status was investigated by anthropometric measurements, (weight, height, arm and leg circumferences and skinfold thickness) and bioelectrical impedance assessment was performed. Blood samples were analyzed for C-reactive protein (CRP) and fibrinogen.

Result: Working capacity was positively related to forced expiratory volume in 1 s (FEV(1)) (p < 0.001), body mass index and fat free mass index (p = 0.01) and negatively related to CRP (p = 0.02) and fibrinogen (p = 0.03). Incremental shuttle walk test was positively related to FEV(1) (p < 0.001) and negatively to CRP (p = 0.048). Hand grip strength was positively related to fat free mass index, and arm and leg circumferences. Fifty to 76% of the variation in physical capacity was accounted for when age, gender, FEV(1), fat free mass index and CRP were combined in a multiple regression model.

Conclusion: Physical capacity in chronic obstructive pulmonary disease is related to lung function, body composition and systemic inflammation. A depiction of all three aspects of the disease might be important when targeting interventions in chronic obstructive pulmonary disease.

Place, publisher, year, edition, pages
2011. Vol. 5, no 3, 136-142 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-97938DOI: 10.1111/j.1752-699X.2010.00208.xISI: 000292361500004OAI: oai:DiVA.org:uu-97938DiVA: diva2:173063
Available from: 2008-12-22 Created: 2008-12-22 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Nutritional Depletion in Chronic Obstructive Pulmonary Disease (COPD): Effect on Morbidity, Mortality and Physical Capacity
Open this publication in new window or tab >>Nutritional Depletion in Chronic Obstructive Pulmonary Disease (COPD): Effect on Morbidity, Mortality and Physical Capacity
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this work was to examine the effects of depleted nutritional status on some aspects of Chronic Obstructive Pulmonary Disease (COPD).

Morbidity. In paper І, we found that energy intake was lower than the calculated energy demand for all patients. A low body mass index (BMI) at inclusion and weight loss, during the one year follow-up period were independent risk factors for having a new exacerbation (p = 0.003 and 0.006, respectively).

Mortality. Nineteen percent of the patients in paper ІІ, where underweight (BMI<20). A significant positive correlation was found between BMI and FEV1, and this correlation remained significant after adjustment for age, sex and pack years (p<0.0001). Being underweight was related to increased overall mortality and respiratory mortality but not to mortality of other causes, 19% of the patients had died within 2 years. The lowest mortality was found among the overweight patients (BMI 25-30 kg/m).

Physical capacity and effect of training. In paper ІІІ we investigated baseline characteristics of patients that were starting physical training. We found that peak working capacity was positively related to BMI (r=0.35, p=0.02) and fat free mass index (FFMI) (r=0.49, p=0.004) and negatively related to S-Fibrinogen and serum C reactive protein (S-CRP). BMI and FFMI were significantly related to the 12 minutes walking distance when adjusted for body weight. Fifty to 76% of the variation in physical capacity was accounted for when age, gender, FEV1, FFMI and CRP were combined in a multiple regression model.

In Paper ІV the median change in fat free mass (FFM), after 4 months of physical training was 0.5 kg. Old age, low FEV1 and high level of dyspnoea were independent negative predictors of FFM increase after the training period.

In conclusion nutritional status is an important determinant of morbidity, mortality and physical capacity in COPD. Low FEV1 and high level of dyspnea are negative predictors for increased FFM after physical training.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2009. 55 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 411
Keyword
chronic obstructive pulmonary disease, nutrition, pulmonary rehabilitation, physical capasity, systemic inflammation
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-9512 (URN)978-91-554-7381-5 (ISBN)
Public defence
2009-01-16, Roberg salen, A9, Ing 40, 5 tr, Akademiska sjukhuset, Uppsala, 09:15
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Supervisors
Available from: 2008-12-22 Created: 2008-12-22Bibliographically approved

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Hallin, RunaJanson, ChristerArnardottir, HarpaOlsson, RogerEmtner, MargaretaBranth, StefanBoman, Gunnar

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