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Zotti S, Luci I, Finamore P, Travaglino F, Pedone C, Antonelli Incalzi R. Handgrip Strength Test and Bioelectrical Impedance Analysis in SARS-CoV-2 Patients Admitted to Sub-Intensive Unit. Nutrients 2023; 15:nu15081979. [PMID: 37111197 PMCID: PMC10142194 DOI: 10.3390/nu15081979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 03/25/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
Hospitalized patients with respiratory failure due to SARS-CoV-2 pneumonia are at increased risk of malnutrition and related mortality. The predictive value of the Mini-Nutritional Assessment short form (MNA-sf®), hand-grip strength (HGS), and bioelectrical impedance analysis (BIA) was determined with respect to in-hospital mortality or endotracheal intubation. The study included 101 patients admitted to a sub-intensive care unit from November 2021 to April 2022. The discriminative capacity of MNA-sf, HGS, and body composition parameters (skeletal mass index and phase angle) was assessed computing the area under the receiver operating characteristic curves (AUC). Analyses were stratified by age groups (<70/70+ years). The MNA-sf alone or in combination with HGS or BIA was not able to reliably predict our outcome. In younger participants, HGS showed a sensitivity of 0.87 and a specificity of 0.54 (AUC: 0.77). In older participants, phase angle (AUC: 0.72) was the best predictor and MNA-sf in combination with HGS had an AUC of 0.66. In our sample, MNA- sf alone, or in combination with HGS and BIA was not useful to predict our outcome in patients with COVID-19 pneumonia. Phase angle and HGS may be useful tools to predict worse outcomes in older and younger patients, respectively.
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Affiliation(s)
- Sonia Zotti
- Department of Medicine and Surgery, Internship Program in Geriatrics, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy
| | - Isabella Luci
- Department of Medicine and Surgery, Internship Program in Geriatrics, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy
| | - Panaiotis Finamore
- Operative Research Unit of Internal Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 21-00128 Roma, Italy
| | - Francesco Travaglino
- Operative Research Unit of Emergency Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 21-00128 Roma, Italy
| | - Claudio Pedone
- Department of Medicine and Surgery, Research Unit of Geriatrics, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy
- Operative Research Unit of Geriatrics, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 21-00128 Roma, Italy
| | - Raffaele Antonelli Incalzi
- Operative Research Unit of Internal Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 21-00128 Roma, Italy
- Department of Medicine and Surgery, Research Unit of Geriatrics, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy
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van der Ende M, Plas RLC, van Dijk M, Dwarkasing JT, van Gemerden F, Sarokhani A, Swarts HJM, van Schothorst EM, Grefte S, Witkamp RF, van Norren K. Effects of whole-body vibration training in a cachectic C26 mouse model. Sci Rep 2021; 11:21563. [PMID: 34732809 PMCID: PMC8566567 DOI: 10.1038/s41598-021-98665-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 07/20/2021] [Indexed: 12/02/2022] Open
Abstract
Targeted exercise combined with nutritional and pharmacological strategies is commonly considered to be the most optimal strategy to reduce the development and progression of cachexia. For COPD patients, this multi-targeted treatment has shown beneficial effects. However, in many, physical activity is seriously hampered by frailty and fatigue. In the present study, effects of whole-body-vibration-training (WBV) were investigated, as potential alternative to active exercise, on body mass, muscle mass and function in tumour bearing mice. Twenty-four male CD2F1-mice (6–8 weeks, 21.5 ± 0.2 g) were stratified into four groups: control, control + WBV, C26 tumour-bearing, and C26 tumour-bearing + WBV. From day 1, whole-body-vibration was daily performed for 19 days (15 min, 45 Hz, 1.0 g acceleration). General outcome measures included body mass and composition, daily activity, blood analysis, assessments of muscle histology, function, and whole genome gene expression in m. soleus (SOL), m. extensor digitorum longus (EDL), and heart. Body mass, lean and fat mass and EDL mass were all lower in tumour bearing mice compared to controls. Except from improved contractility in SOL, no effects of vibration training were found on cachexia related general outcomes in control or tumour groups, as PCA analysis did not result in a distinction between corresponding groups. However, analysis of transcriptome data clearly revealed a distinction between tumour and trained tumour groups. WBV reduced the tumour-related effects on muscle gene expression in EDL, SOL and heart. Gene Set Enrichment Analysis showed that these effects were associated with attenuation of the upregulation of the proteasome pathway in SOL. These data suggest that WBV had minor effects on cachexia related general outcomes in the present experimental set-up, while muscle transcriptome showed changes associated with positive effects. This calls for follow-up studies applying longer treatment periods of WBV as component of a multiple-target intervention.
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Affiliation(s)
- Miranda van der Ende
- Division Human Nutrition and Health, Nutritional Biology and Health, Wageningen University & Research, Wageningen, The Netherlands.,Human and Animal Physiology, Wageningen University & Research, Wageningen, The Netherlands
| | - Rogier L C Plas
- Division Human Nutrition and Health, Nutritional Biology and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Miriam van Dijk
- Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, The Netherlands
| | - Jvalini T Dwarkasing
- Division Human Nutrition and Health, Nutritional Biology and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Frans van Gemerden
- Division Human Nutrition and Health, Nutritional Biology and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Attusa Sarokhani
- Division Human Nutrition and Health, Nutritional Biology and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Hans J M Swarts
- Human and Animal Physiology, Wageningen University & Research, Wageningen, The Netherlands
| | - Evert M van Schothorst
- Human and Animal Physiology, Wageningen University & Research, Wageningen, The Netherlands
| | - Sander Grefte
- Human and Animal Physiology, Wageningen University & Research, Wageningen, The Netherlands
| | - Renger F Witkamp
- Division Human Nutrition and Health, Nutritional Biology and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Klaske van Norren
- Division Human Nutrition and Health, Nutritional Biology and Health, Wageningen University & Research, Wageningen, The Netherlands.
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3
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Hedhli A, Slim A, Mjid M, Ouachi Y, Kacem M, Cheikh Rouhou S, Merai S, Toujani S, Dhahri B. [Nutritional status and dietary intake in patients with chonic obstructive pulmonary disease]. Rev Mal Respir 2021; 38:689-697. [PMID: 34092448 DOI: 10.1016/j.rmr.2021.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 04/13/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Undernutrition is a predictor of mortality in chronic obstructive pulmonary disease (COPD). The objectives of our study were to assess nutritional intake in COPD and to study its relationship with disease severity. METHODS A cross-sectional study that included 66 patients followed for COPD. Patients included had a body composition study and a respiratory and nutritional assessment. RESULTS The mean age of the population was 66±9 years. The lean body mass index (LMI) was reduced in 26.1% of patients. It was significantly associated with the GOLD group (P=0.04) and significantly correlated with the forced expiratory volume in the first second (FEV1) (P=0.02) and the distance covered during the six-minute walk test (TM6) (P=0.01). A significant difference was found between the caloric intakes and the different GOLD groups (P=0.04). Mean intakes of calories (P=0.002; r=0.07), protein (P=0.01; r=0.16), carbohydrates (P=0.02; r=0.2) and iron (P=0.01; r=0.13) were significantly correlated with the TM6 results. Caloric intake was significantly correlated with LMI (P=0.01; r=0.16), body mass index (P=0.04; r=0.12), FEV1 (P=0.04; r=-0.12) and GOLD stage (0.002). Similarly, protein intake was significantly correlated with LMI (P=0.001; r=0.11), body mass index (P=0.02; r=0.16), FEV1(%) (P=0.001; r=-0.16) and GOLD stage (P=0.002). CONCLUSION Undernutrition in COPD is caused by decreased food intake and increased resting energy expenditure. Adequate intakes of glucose, protein, fibers, vitamins and zinc are associated with improved ventilatory function.
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Affiliation(s)
- A Hedhli
- Service de pneumologie, faculté de médecine de Tunis, université Tunis El Manar, CHU la Rabta, rue Jbel Lakhdar La Rabta, LR18SP02, 1007 Tunis, Tunisie
| | - A Slim
- Service de pneumologie, faculté de médecine de Tunis, université Tunis El Manar, CHU la Rabta, rue Jbel Lakhdar La Rabta, LR18SP02, 1007 Tunis, Tunisie.
| | - M Mjid
- Service de pneumologie, faculté de médecine de Tunis, université Tunis El Manar, CHU la Rabta, rue Jbel Lakhdar La Rabta, LR18SP02, 1007 Tunis, Tunisie
| | - Y Ouachi
- Service de pneumologie, faculté de médecine de Tunis, université Tunis El Manar, CHU la Rabta, rue Jbel Lakhdar La Rabta, LR18SP02, 1007 Tunis, Tunisie
| | - M Kacem
- Service de pneumologie, faculté de médecine de Tunis, université Tunis El Manar, CHU la Rabta, rue Jbel Lakhdar La Rabta, LR18SP02, 1007 Tunis, Tunisie
| | - S Cheikh Rouhou
- Service de pneumologie, faculté de médecine de Tunis, université Tunis El Manar, CHU la Rabta, rue Jbel Lakhdar La Rabta, LR18SP02, 1007 Tunis, Tunisie
| | - S Merai
- Service de pneumologie, faculté de médecine de Tunis, université Tunis El Manar, CHU la Rabta, rue Jbel Lakhdar La Rabta, LR18SP02, 1007 Tunis, Tunisie
| | - S Toujani
- Service de pneumologie, faculté de médecine de Tunis, université Tunis El Manar, CHU la Rabta, rue Jbel Lakhdar La Rabta, LR18SP02, 1007 Tunis, Tunisie
| | - B Dhahri
- Service de pneumologie, faculté de médecine de Tunis, université Tunis El Manar, CHU la Rabta, rue Jbel Lakhdar La Rabta, LR18SP02, 1007 Tunis, Tunisie
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Low BMI and weight loss aggravate COPD mortality in men, findings from a large prospective cohort: the JACC study. Sci Rep 2021; 11:1531. [PMID: 33452329 PMCID: PMC7810869 DOI: 10.1038/s41598-020-79860-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/12/2020] [Indexed: 12/18/2022] Open
Abstract
To clarify how low BMI and weight loss were associated with risk of chronic obstructive pulmonary disease (COPD) mortality, in a large prospective cohort of the general population across Japan, the Japan Collaborative Cohort Study, conducted between 1988 and 2009. A total of 45,837 male residents were observed for a median period of 19.1 years. Self-administered questionnaires, collecting information on BMI, weight loss since the age of 20, lifestyles, history of diseases, as well as records of COPD mortality, were analysed at 2019. During follow-up, 268 participants died from COPD. The multivariate-adjusted hazard ratio (95% confidence interval) of COPD mortality associated with a 1-SD increment of body mass index (BMI) was 0.48 (0.41–0.57), while for weight change from age of 20 (+ 2.0 kg) it was 0.63 (0.59–0.68). These associations were persistently observed after stratifications with smoking status, excluding those having airway symptoms in the baseline survey, and excluding early COPD deaths within 5, 10 and 15 years. Our study suggests that BMI and weight change since the age of 20 could be markers for COPD prognosis, indicated by risk of COPD mortality.
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Vaughan A, Frazer ZA, Hansbro PM, Yang IA. COPD and the gut-lung axis: the therapeutic potential of fibre. J Thorac Dis 2019; 11:S2173-S2180. [PMID: 31737344 DOI: 10.21037/jtd.2019.10.40] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Current management strategies for chronic obstructive pulmonary disease (COPD) incorporate a step-wise, multidisciplinary approach to effectively manage patient symptoms and prevent disease progression. However, there has been limited advancement in therapies to address the underlying cause of COPD pathogenesis. Recent research has established the link between the lungs and the gut-the gut-lung axis -and the gut microbiome is a major component. The gut microbiome is likely perturbed in COPD, contributing to chronic inflammation. Diet is a readily modifiable factor and the diet of COPD patients is often deficient in nutrients such as fibre. The metabolism of dietary fibre by gut microbiomes produces anti-inflammatory short chain fatty acid (SCFAs), which could protect against inflammation in the lungs. By addressing the 'fibre gap' in the diet of COPD patients, this targeted dietary intervention may reduce inflammation, both systemically and in the airways, and value-add to the paradigm shift in respiratory medicine, from reactive to personalised and participatory medicine.
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Affiliation(s)
- Annalicia Vaughan
- UQ Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Chermside, Brisbane, Australia.,Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Australia
| | - Zoe A Frazer
- UQ Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Chermside, Brisbane, Australia.,Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Australia
| | - Philip M Hansbro
- Centre for Inflammation, Centenary Institute, University of Technology Sydney, Faculty of Science, Camperdown, Australia.,Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, Callaghan, Australia
| | - Ian A Yang
- UQ Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Chermside, Brisbane, Australia.,Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Australia
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Nguyen HT, Collins PF, Pavey TG, Nguyen NV, Pham TD, Gallegos DL. Nutritional status, dietary intake, and health-related quality of life in outpatients with COPD. Int J Chron Obstruct Pulmon Dis 2019; 14:215-226. [PMID: 30666102 PMCID: PMC6336029 DOI: 10.2147/copd.s181322] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Malnutrition is common in patients with COPD; however, little is known about its impacts on health-related quality of life (QoL) among patients with COPD. This study aimed to explore the nutritional status and dietary intake among outpatients with COPD in Vietnam and its possible associations with QoL. Methods A cross-sectional study was carried out in COPD outpatients visiting the COPD management unit at the National Lung Hospital, Hanoi, Vietnam between May 2017 and July 2017. Consecutive outpatients with a confirmed diagnosis of COPD were recruited with written inform consent. The nutritional status of participants was assessed using Subjective Global Assessment (SGA), and dietary intake via a 24-hour recall interview. The St George Respiratory Questionnaire (SGRQ) for COPD was used to investigate the participants’ QoL. Sociodemographic and clinical data were extracted from hospital records. Results Of 168 COPD outpatients involved in the study, three-quarters (74.4%) were diagnosed as malnourished (SGA B/C) and 81.5% reported unintentional weight loss. Most of the patients did not meet their estimated energy and protein requirements (85.7% and 89.9%, respectively). Malnutrition was significantly associated with disease severity (P=0.039) and ratio of protein intake to estimated requirement (P=0.005). QoL was low for all levels of malnutrition or disease severity, with well-nourished participants and those with less disease severity having better QoL (P=0.006 and P<0.001, respectively). With an extra meal per day, the odds of having malnutrition decreased 5.6 times (P<0.05) and the total SGRQ reduced 3.61 scores (P<0.05) indicating a better QoL. Conclusion Malnutrition and weight loss are prevalent among COPD outpatients. Most of the patients had inadequate dietary intake and low QoL. Nutrition counselling including increasing the number of meals per day with a focus on energy- and protein-rich foods may help improving nutritional status and QoL of patients with COPD in Vietnam.
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Affiliation(s)
- Ha Thanh Nguyen
- School of Exercise and Nutrition Sciences, Faculty of Health Queensland University of Technology, Kelvin Grove, QLD, Australia, .,Department of Nutrition and Food Safety, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam,
| | - Peter F Collins
- School of Exercise and Nutrition Sciences, Faculty of Health Queensland University of Technology, Kelvin Grove, QLD, Australia, .,Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Australia
| | - Toby G Pavey
- School of Exercise and Nutrition Sciences, Faculty of Health Queensland University of Technology, Kelvin Grove, QLD, Australia,
| | | | - Tuong Duy Pham
- Department of Nutrition and Food Safety, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam,
| | - Danielle L Gallegos
- School of Exercise and Nutrition Sciences, Faculty of Health Queensland University of Technology, Kelvin Grove, QLD, Australia,
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Maia I, Xará S, Vaz D, Shiang T, Amaral T. Undernutrition risk at hospital admission and length of stay among pulmonology inpatients. Pulmonology 2018; 24:330-336. [DOI: 10.1016/j.pulmoe.2018.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 12/21/2017] [Accepted: 01/13/2018] [Indexed: 12/13/2022] Open
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Witkamp RF, van Norren K. Let thy food be thy medicine….when possible. Eur J Pharmacol 2018; 836:102-114. [DOI: 10.1016/j.ejphar.2018.06.026] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 06/06/2018] [Accepted: 06/19/2018] [Indexed: 02/09/2023]
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De Benedetto F, Pastorelli R, Ferrario M, de Blasio F, Marinari S, Brunelli L, Wouters EFM, Polverino F, Celli BR. Supplementation with Qter ® and Creatine improves functional performance in COPD patients on long term oxygen therapy. Respir Med 2018; 142:86-93. [PMID: 30170808 DOI: 10.1016/j.rmed.2018.08.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 08/01/2018] [Accepted: 08/05/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Skeletal muscle dysfunction and poor functional capacity are important extra-pulmonary manifestations of chronic obstructive pulmonary disease (COPD), especially in COPD patients on long-term O2 therapy (LTOT). Beside the role of pulmonary rehabilitation, the effect of nutritional interventions is still controversial, and there are knowledge gaps on the effective role of nutraceutical supplementation on hard endpoints. The aim of this study was to investigate the effects of nutritional supplementation with Coenzyme Q10 (QTer®) - a powerful antioxidant with the potential to reduce oxidative stress and improve mitochondrial function - and Creatine on functional, nutritional, and metabolomic profile in COPD patients on long-term O2 therapy. METHODS One-hundred and eight patients with COPD from 9 Italian hospitals were enrolled in this double-blinded randomized placebo-controlled clinical study. At baseline and after 2 months of therapy, the patients underwent spirometry, 6-minute walk test (6MWT), bioelectrical impedance analysis, and activities of daily living questionnaire (ADL). Also, dyspnea scores and BODE index were calculated. At both time points, plasma concentration of CoQ10 and metabolomic profiling were measured. FINDINGS Ninety patients, who randomly received supplementation with QTer® and Creatine or placebo, completed the study. Compared with placebo, supplemented patients showed improvements in 6MWT (51 ± 69 versus 15 ± 91 m, p < 0.05), body cell mass and phase angle, sodium/potassium ratio, dyspnea indices and ADL score. The CoQ10 plasma concentration increased in the supplementation group whereas it did not change in the placebo group. The metabolomics profile also differed between groups. Adverse events were similar in both groups. INTERPRETATION These results show that in patients with COPD, dietary supplementation with CoQ10 and Creatine improves functional performance, body composition and perception of dyspnea. A systemic increase in some anti-inflammatory metabolites supports a pathobiological mechanism as a reason for these benefits. Further trials should help clarifying the role of QTer® and Creatine supplementation in patients with COPD.
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Affiliation(s)
| | - Roberta Pastorelli
- Department of Environmental Health Science, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy
| | - Manuela Ferrario
- Department of Electronics, Information, and Bioengineering (DEIB), Politecnico di Milano, Milan, Italy
| | | | | | - Laura Brunelli
- Department of Environmental Health Science, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy
| | - Emiel F M Wouters
- Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, Netherlands
| | | | - Bartolome R Celli
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
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Hoang BX, Han B, Nguyen HX, Dang KT. Nutritional Supplement "Bao Khi Khang" as an Adjuvant Therapy in Acute Exacerbations of Chronic Obstructive Pulmonary Disease. J Med Food 2018; 21:1053-1059. [PMID: 29683370 DOI: 10.1089/jmf.2017.0115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
To investigate the effectiveness of nutritional supplement Bao Khi Khang as an adjuvant therapy in acute exacerbations of chronic obstructive pulmonary disease (COPD) compared to conventional therapy alone. This was a prospective, randomized, open-label controlled trial in 60 patients presenting with acute exacerbation of COPD. Patients were randomized into two groups, the control and the experimental groups. The control group was treated with the standard therapeutic protocol (Antimicrobial+Corticosteroids+Bronchodilator+Mucolytic drugs). The experimental group was treated with Bao Khi Khang tablets combined with the standard therapeutic protocol. The treatment outcomes, including clinical and paraclinical parameters of exacerbation of COPD, were compared between the experimental group and the control group at day 15 and 30. This study was conducted according to protocol: 01.2014-HTNCKH. The results showed a significant reduction of major COPD exacerbation symptoms in experimental group. The favorable progresses in mMRC scale and COPD Assessment Test score before and after treatment, between experimental group and control group, were statistically different. Symptom control such as cough, copious sputum secretion, and bacterial infection was 90% effective (very good 50.0%, good 40.0%) in experimental group compared to 50% (very good 20%, good 30.0%) in control group. No adverse side effects were observed in experimental group. Bao Khi Khang nutritional supplement could be an effective and safe adjuvant therapy in acute exacerbations of COPD. Further interventional studies are required to confirm these findings.
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Affiliation(s)
- Ba X Hoang
- 1 International Medical Consultants Co., Ltd. , Hanoi, Vietnam .,2 Nimni-Cordoba Tissue Engineering and Drug Discovery Laboratory, Division of Plastic and Reconstructive Surgery, Department of Surgery, Keck School of Medicine, University of Southern California , Los Angeles, California, USA
| | - Bo Han
- 1 International Medical Consultants Co., Ltd. , Hanoi, Vietnam
| | - Hoang X Nguyen
- 2 Nimni-Cordoba Tissue Engineering and Drug Discovery Laboratory, Division of Plastic and Reconstructive Surgery, Department of Surgery, Keck School of Medicine, University of Southern California , Los Angeles, California, USA
| | - Khanh T Dang
- 2 Nimni-Cordoba Tissue Engineering and Drug Discovery Laboratory, Division of Plastic and Reconstructive Surgery, Department of Surgery, Keck School of Medicine, University of Southern California , Los Angeles, California, USA
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Collins P, Elia M, Kurukulaaratchy R, Stratton R. The influence of deprivation on malnutrition risk in outpatients with chronic obstructive pulmonary disease (COPD). Clin Nutr 2018; 37:144-148. [DOI: 10.1016/j.clnu.2016.11.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 10/31/2016] [Accepted: 11/01/2016] [Indexed: 11/30/2022]
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12
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de Blasio F, Di Gregorio A, de Blasio F, Bianco A, Bellofiore B, Scalfi L. Malnutrition and sarcopenia assessment in patients with chronic obstructive pulmonary disease according to international diagnostic criteria, and evaluation of raw BIA variables. Respir Med 2018; 134:1-5. [DOI: 10.1016/j.rmed.2017.11.006] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 11/05/2017] [Accepted: 11/07/2017] [Indexed: 01/07/2023]
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Abstract
Introduction Cachexia is a common complication of many and varied chronic disease processes, yet it has received very little attention as an area of clinical research effort until recently. We sought to survey the contemporary literature on published research into cachexia to define where it is being published and the proportion of output classified into the main types of research output. Methods I searched the PubMed listings under the topic research term "cachexia" and related terms for articles published in the calendar years of 2015 and 2016, regardless of language. Searches were conducted and relevant papers extracted by two observers, and disagreements were resolved by consensus. Results There were 954 publications, 370 of which were review articles or commentaries, 254 clinical observations or non-randomised trials, 246 original basic science reports and only 26 were randomised controlled trials. These articles were published in 478 separate journals but with 36% of them being published in a core set of 23 journals. The H-index of these papers was 25 and there were 147 papers with 10 or more citations. Of the top 100 cited papers, 25% were published in five journals. Of the top cited papers, 48% were review articles, 18% were original basic science, and 7% were randomised clinical trials. Discussion This analysis shows a steady but modest increase in publications concerning cachexia with a strong pipeline of basic science research but still a relative lack of randomised clinical trials, with none exceeding 1000 patients. Research in cachexia is still in its infancy, but the solid basic science effort offers hope that translation into randomised controlled clinical trials may eventually lead to effective therapies for this troubling and complex clinical disease process.
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Bruno A, Uasuf CG, Insalaco G, Barazzoni R, Ballacchino A, Gjomarkaj M, Pace E. Nutritional status and physical inactivity in moderated asthmatics: A pilot study. Medicine (Baltimore) 2016; 95:e4485. [PMID: 27495092 PMCID: PMC4979846 DOI: 10.1097/md.0000000000004485] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Preservation of nutritional status and of fat-free mass (FFM) and/or preventing of fat mass (FM) accumulation have a positive impact on well-being and prognosis in asthma patients. Physical inactivity is identified by World Health Organization as the fourth leading risk factor for global mortality. Physical activity (PA) may contribute to limit FM accumulation, but little information is available on the interactions between habitual PA and body composition and their association with disease severity in asthma severity.Associations between habitual PA, FM, FFM, and pulmonary function were investigated in 42 subjects (24 patients with mild-moderate asthma and 18 matched control subjects). Sensewear Armband was used to measure PA and metabolic equivalent of tasks (METs) continuously over 4 days, while body composition was measured by bioelectrical impedance analysis. Respiratory functions were also assessed in all study participants.FM and FFM were comparable in mild-moderate asthmatics and controls, but PA was lower in asthmatics and it was negatively correlated with FM and positively with the FFM marker body cell mass in all study subjects (P < 0.05). Among asthmatics, treated moderate asthmatics (ICS, n = 12) had higher FM and lower PA, METs, steps number/die, and forced expiratory volume in the 1st second (FEV1)/forced vital capacity (FVC) than in untreated intermittent asthmatics (UA, n = 12).This pilot study assesses that in mild-moderate asthma patients, lower PA is associated with higher FM and higher disease severity. The current results support enhancement of habitual PA as a potential tool to limit FM accumulation and potentially contribute to preserve pulmonary function in moderate asthma, considering the physical inactivity a strong risk factor for asthma worsening.
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Affiliation(s)
- Andreina Bruno
- CNR, Institute of Biomedicine and Molecular Immunology, Palermo
- Correspondence: Andreina Bruno, Istituto di Biomedicina e Immunologia Molecolare [IBIM], Consiglio Nazionale delle Ricerche [CNR] Via Ugo La Malfa, 153, 90146 Palermo, Italy (e-mail: )
| | | | | | - Rocco Barazzoni
- Internal Medicine, Department of Medical, Surgical and Health Sciences, University of Trieste, and Azienda Ospedaliera “Ospedali Riuniti,” Trieste, Italy
| | | | - Mark Gjomarkaj
- CNR, Institute of Biomedicine and Molecular Immunology, Palermo
| | - Elisabetta Pace
- CNR, Institute of Biomedicine and Molecular Immunology, Palermo
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15
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Hogan D, Lan LTT, Diep DTN, Gallegos D, Collins PF. Nutritional status of Vietnamese outpatients with chronic obstructive pulmonary disease. J Hum Nutr Diet 2016; 30:83-89. [DOI: 10.1111/jhn.12402] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- D. Hogan
- Nutrition and Dietetics; School of Exercise and Nutrition Sciences; Faculty of Health; Queensland University of Technology; Kelvin Grove QLD Australia
| | - L. T. T. Lan
- Respiratory Care Center; University of Medicine and Pharmacy; Ho Chi Minh City Vietnam
| | | | - D. Gallegos
- Nutrition and Dietetics; School of Exercise and Nutrition Sciences; Faculty of Health; Queensland University of Technology; Kelvin Grove QLD Australia
| | - P. F. Collins
- Nutrition and Dietetics; School of Exercise and Nutrition Sciences; Faculty of Health; Queensland University of Technology; Kelvin Grove QLD Australia
- Department of Nutrition and Dietetics; Princess Alexandra Hospital; Woolloongabba QLD Australia
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