Evaluation of nutritional status and physical performance in patients with chronic obstructive pulmonary disease [Procjena nutritivnog statusa i fizičke sposobnosti bolesnika s kroničnom opstrukcijskom bolešću pluća]

Matković, Zinka (2018) Evaluation of nutritional status and physical performance in patients with chronic obstructive pulmonary disease [Procjena nutritivnog statusa i fizičke sposobnosti bolesnika s kroničnom opstrukcijskom bolešću pluća]. PhD thesis, Sveučilište u Zagrebu.

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Abstract

Physical inactivity and skeletal muscle mass wasting are frequent findings in patients with chronic obstructive pulmonary disease (COPD). The aim of the study was to compare nutritional status and body composition in COPD patients with poor and normal physical performance, which was assessed in three different ways – exercise capacity evaluated by the 6-minute walk test, gait speed measured by the 4-metre gait speed test and physical activity expressed as average daily step count. In the population of 111 patients with moderate to very severe COPD, those with poor physical performance were older, had worse lung function, higher symptom burden, more frequent exacerbations, worse health-related quality of life, and deficient nutritional status, which manifested dominantly with lower parameters of muscle/bone tissue and serum protein levels. There were no significant differences in the body-mass index and parameters related to fat tissue. In the multivariate analysis the variables that were independently and significantly associated with poor exercise capacity were older age, previous exacerbations, lung hyperinflation, reduced lung diffusion capacity and higher dyspnoea level. Likewise, older age, reduced lung diffusion capacity and dyspnoea level were independently associated with poor physical activity. However, none of the nutritional parameters were independently related to poor physical performance.

Abstract in Croatian

Tjelesna neaktivnost i gubitak skeletne mišićne mase su česti u bolesnika s kroničnom opstrukcijskom bolešću pluća (KOPB). Cilj istraživanja je bio usporediti nutritivni status i tjelesni sastav u KOPB bolesnika sa smanjenom i normalnom fizičkom sposobnošću koja je procijenjena na tri različita načina – tjelesnom kondicijom na temelju 6-minutnog testa hoda, brzinom hoda mjerenom testom brzine hoda na 4 metra i tjelesnom aktivnošću izraženom prosječnim dnevnim brojem koraka. U populaciji od 111 bolesnika s umjereno teškim do vrlo teškim KOPB-om, bolesnici sa smanjenom fizičkom sposobnošću su bili stariji, imali lošiju plućnu funkciju, izraženije simptome, češće egzacerbacije, slabiju kvalitetu života i lošiji nutritivni status što se u prvom redu manifestiralo nižim vrijednostima parametara mišićno-koštane mase i nižim vrijednostima serumskih proteina. Nije bilo značajne razlike u indeksu tjelesne mase niti u parametrima koji se odnose na masno tkivo. Multivarijantnom analizom je utvrđeno da su starija dob, prethodne egzacerbacije, hiperinflacija pluća, smanjen difuzijski kapacitet pluća i viši stupanj zaduhe nezavisno i statistički značajno povezani sa smanjenom tjelesnom kondicijom. Jednako tako su starija dob, smanjen difuzijski kapacitet pluća i viši stupanj zaduhe bili nezavisno povezani sa smanjenom tjelesnom aktivnošću. Nijedan nutritivni parametar nije pokazao nezavisnu povezanost sa smanjenom fizičkom sposobnošću.

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