Resting energy expenditure and carbohydrate oxidation are higher in elderly patients with COPD: a case control study

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Abstract

Background

Elderly patients with chronic obstructive pulmonary disease (COPD) usually have a compromised nutritional status which is an independent predictor of morbidity and mortality. To know the Resting Energy Expenditure (REE) and the substrate oxidation measurement is essential to prevent these complications. This study aimed to compare the REE, respiratory quotient (RQ) and body composition between patients with and without COPD.

Methods

This case–control study assessed 20 patients with chronic obstructive pulmonary disease attending a pulmonary rehabilitation program. The group of subjects without COPD (control group) consisted of 20 elderly patients attending a university gym, patients of a private service and a public healthy care. Consumption of oxygen (O ₂) and carbon dioxide (CO ₂) was determined by indirect calorimetry and used for calculating the resting energy expenditure and respiratory quotient. Body mass index (BMI) and waist circumference (WC) were also measured. Percentage of body fat (%BF), lean mass (kg) and muscle mass (kg) were determined by bioimpedance. The fat free mass index (FFMI) and muscle mass index (MMI) were then calculated.

Results

The COPD group had lower BMI than control (p = 0.02). However, WC, % BF, FFMI and MM-I did not differ between the groups. The COPD group had greater RQ (p = 0.01), REE (p = 0.009) and carbohydrate oxidation (p = 0.002).

Conclusions

Elderly patients with COPD had higher REE, RQ and carbohydrate oxidation than controls.

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Most cited references 23

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Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary.

R A Pauwels, A Buist, P. Calverley … (2001)

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Estimation of skeletal muscle mass by bioelectrical impedance analysis.

Ian Janssen, Steven B Heymsfield, Richard N. Baumgartner … (2000)

The purpose of this study was to develop and cross-validate predictive equations for estimating skeletal muscle (SM) mass using bioelectrical impedance analysis (BIA). Whole body SM mass, determined by magnetic resonance imaging, was compared with BIA measurements in a multiethnic sample of 388 men and women, aged 18-86 yr, at two different laboratories. Within each laboratory, equations for predicting SM mass from BIA measurements were derived using the data of the Caucasian subjects. These equations were then applied to the Caucasian subjects from the other laboratory to cross-validate the BIA method. Because the equations cross-validated (i.e., were not different), the data from both laboratories were pooled to generate the final regression equation SM mass (kg) = [(Ht 2 / R x 0.401) + (gender x 3.825) + (age x -0. 071)] + 5.102 where Ht is height in centimeters; R is BIA resistance in ohms; for gender, men = 1 and women = 0; and age is in years. The r(2) and SE of estimate of the regression equation were 0.86 and 2.7 kg (9%), respectively. The Caucasian-derived equation was applicable to Hispanics and African-Americans, but it underestimated SM mass in Asians. These results suggest that the BIA equation provides valid estimates of SM mass in healthy adults varying in age and adiposity.

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Body mass and fat-free mass indices in COPD: relation with variables expressing disease severity.

Nikolaos Koulouris, I Papa, E Gaki … (2007)

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. 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 (FEV(1), FEV(1)/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(4) in supernatant), and quality of life (emotional part of the chronic respiratory disease questionnaire). 6MWD was significantly associated with both BMI and FFMI values, while FFMI additionally presented significant correlations with MRC scale, percentage of predicted FEV(1), and FEV(1)/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. 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.

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Author and article information

Journal

Journal ID (nlm-ta): Nutr J

Journal ID (iso-abbrev): Nutr J

Title: Nutrition Journal

Publisher: BioMed Central

ISSN (Electronic): 1475-2891

Publication date Collection: 2012

Publication date (Electronic): 6 June 2012

Volume: 11

Page: 37

Affiliations

[1 ]Universidade Metodista de Piracicaba (UNIMEP), Lins, SP, Brazil

[2 ]Department of Pathology, São Paulo State University (UNESP), Botucatu, SP, Brazil

[3 ]Department of Public Health, Centre for Physical and Nutritional Metabolism (CeMENutri), São Paulo State University (UNESP), Botucatu, SP, Brazil

[4 ]Department of Internal Medicine, Campinas State University (UNICAMP), Campinas, SP, Brazil

[5 ]Department of Physiotherapy, Centro Universitário Católico Salesiano Auxilium-Unisalesiano, Lins, SP, Brazil

[6 ]CeMENutri - Faculdade de Medicina, Depto. de Saúde Pública (FMB - UNESP), Distrito de Rubião Jr, s/n°, 18.618-970, Botucatu, SP, Brazil

Article

Publisher ID: 1475-2891-11-37

DOI: 10.1186/1475-2891-11-37

PMC ID: 3502439

PubMed ID: 22672689

SO-VID: e697fa83-7259-4a95-8cce-3cedd31dfe10

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Resting energy expenditure and carbohydrate oxidation are higher in elderly patients with COPD: a case control study

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Abstract

Background

Methods

Results

Conclusions

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Biomarkers for Inflammatory Lung Disease

Most cited references 23

Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary.

Estimation of skeletal muscle mass by bioelectrical impedance analysis.

Body mass and fat-free mass indices in COPD: relation with variables expressing disease severity.

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