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      Relationship between nutritional risk and exercise capacity in severe chronic obstructive pulmonary disease in male patients

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          Abstract

          Objective

          The nutritional status of chronic obstructive pulmonary disease (COPD) patients is associated with their exercise capacity. In the present study, we have explored the relationship between nutritional risk and exercise capacity in severe male COPD patients.

          Methods

          A total of 58 severe COPD male patients were enrolled in this study. The patients were assigned to no nutritional risk group (n=33) and nutritional risk group (n=25) according to the Nutritional Risk Screening (NRS, 2002) criteria. Blood gas analysis, conventional pulmonary function testing, and cardiopulmonary exercise testing were performed on all the patients.

          Results

          Results showed that the weight and BMI of the patients in the nutritional risk group were significantly lower than in the no nutritional risk group ( P<0.05). The pulmonary diffusing capacity for carbon monoxide of the no nutritional risk group was significantly higher than that of the nutritional risk group ( P<0.05). Besides, the peak VO 2 (peak oxygen uptake), peak O 2 pulse (peak oxygen pulse), and peak load of the nutritional risk group were significantly lower than those of the no nutritional risk group ( P<0.05) and there were significantly negative correlations between the NRS score and peak VO 2, peak O 2 pulse, or peak load ( r<0, P<0.05).

          Conclusion

          The association between exercise capacity and nutritional risk based on NRS 2002 in severe COPD male patients is supported by these results of this study.

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          Most cited references 35

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          ATS/ACCP statement on cardiopulmonary exercise testing.

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            Nutritional depletion in relation to respiratory and peripheral skeletal muscle function in out-patients with COPD.

            Although increasing attention has been paid to nutritional aspects in chronic obstructive pulmonary disease (COPD), limited information is available regarding the prevalence and consequences of nutritional depletion in a random out-patient COPD population. We studied body composition in relation to respiratory and peripheral skeletal muscle function in 72 COPD patients (mean (SD) forced expiratory volume in one second (FEV1) 53 (15) % predicted), who came to the lung function laboratory for routine lung function measurements. Patients were characterized by the degree of body weight loss and fat-free mass depletion. According to this definition, 14% of the group suffered from both loss of body weight and depletion of fat-free mass, whereas 7% had one of these conditions. We found that tissue depletion was concomitant with lower values for respiratory and peripheral skeletal muscle strength (46.0 (27.2) vs 77.1 (29.8) kg), and a significantly lower transfer coefficient for carbon monoxide (KCO 64.9 (16.2) vs 81.9 (24.5) % pred). Stratification by KCO ( 80%) also revealed significantly lower values for fat-free mass and higher values for intrathoracic gas volumes, total lung capacity (TLC) and residual volume (RV) in the group with a KCO < 60% pred. Analysis of covariance, taking fat-free mass as covariate, indicated an independent contribution of KCO on maximal inspiratory mouth pressure (PImax) but not on peripheral skeletal muscle strength. It is concluded that a substantial number of COPD out-patients suffer from nutritional depletion, preferentially affecting peripheral skeletal muscle function.
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              Influence of exercise intensity and duration on biochemical adaptations in skeletal muscle.

              The influence of intensity and daily duration of exercise on cytochrome c concentration in the three muscle fiber types was assessed in rats that were treadmill trained for 8 wk (5 days/wk) by 1 of 19 protocols. The importance of exercise duration was determined at six running intensities (10, 20, 30, 40, 50, and 60 m/min). Daily run times resulted in a maximal adaptive change for each running intensity. The general pattern of cytochrome c change, caused by increasing daily run times, followed a first-order manner in all fiber types. The final time-independent asymptotic values were dependent on the intensity of running. In addition, as running intensity was increased, the length of daily run time required to achieve the peak adaptive response was shortened. The intensity influence was very different between fiber types. In the fast-twitch red fiber, the maximal time-independent response at each work intensity was altered by exercise intensity at only submaximal work loads (i.e., the adaptation from 19 to 29 nmol/g was not further increased at 50 and 60 m/min). In contrast, the adaptive response in the fast-twitch white fiber began at 30 m/min (approx 80% VO2max) and increased exponentially as intensity was increased (200% increase at 60 m/min). Whether this different adaptive response between fiber types is due solely to the ordered recruitment of motor units remains to be determined.
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                Author and article information

                Journal
                Int J Chron Obstruct Pulmon Dis
                Int J Chron Obstruct Pulmon Dis
                International Journal of COPD
                International Journal of Chronic Obstructive Pulmonary Disease
                Dove Medical Press
                1176-9106
                1178-2005
                2015
                23 June 2015
                : 10
                : 1207-1212
                Affiliations
                [1 ]Department of Respiratory Medicine, Yangpu Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China
                [2 ]Department of Pulmonary Circulation, Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China
                Author notes
                Correspondence: Jinming Liu, Department of Pulmonary Circulation, Pulmonary Hospital, Tongji University School of Medicine, Zhengmin Road 507, Yangpu District, Shanghai 200433, People’s Republic of China, Tel +86 21 6511 5006, Email jinmingliujml@ 123456126.com
                Article
                copd-10-1207
                10.2147/COPD.S82082
                4484657
                © 2015 Shan et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License

                The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

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                Original Research

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