Nutritional Status In COPD

Ultrafast gas chromatography coupled to electronic nose to identify volatile biomarkers in exhaled breath from chronic obstructive pulmonary disease patients: A pilot study

An analytical method to identify volatile organic compounds (VOCs) in the exhaled breath from patients with a diagnosis of chronic obstructive pulmonary disease (COPD) using a ultrafast gas chromatography system equipped with an electronic nose detector (FGC eNose) has been developed. A prospective study was performed in 23 COPD patients and 33 healthy volunteers; exhalation breathing tests were performed with Tedlar bags. Each sample was analyzed by FCG eNose and the identification of VOCs was based on the Kovats index. Raw data were reduced by principal component analysis (PCA) and canonical discriminant analysis [canonical analysis of principal coordinates (CAP)]. The FCG eNose technology was able to identify 17 VOCs that distinguish COPD patients from healthy volunteers. At all stages of PCA and CAP the discrimination between groups was obvious. Chemical prints were correctly classified up to 82.2%, and were matched with 78.9% of the VOCs detected in the exhaled breath samples. Receiver operating characteristic curve analysis indicated the sensitivity and specificity to be 96% and 91%, respectively. This pilot study demonstrates that FGC eNose is a useful tool to identify VOCs as biomarkers in exhaled breath from COPD patients. Further studies should be performed to enhance the clinical relevance of this quick and ease methodology for COPD diagnosis.

Nutritional evaluation in chronic obstructive pulmonary disease patients

Malnutrition is a common problem in moderate or severe Chronic Obstructive Pulmonary Disease (COPD) patients which affects body composition and food intake of these patients. In this study, the relationship of the stage of COPD with nutritional intake and body mass index in COPD patients were investigated and compared with healthy people and Dietary Reference Intake tables. A total of 93 COPD patients were referred by pulmonary physicians in Motahari and Faghihi medical centers. Pulmonary Function Test (PFT) was used in order to confirm the diagnosis of COPD and also categorize the patients into three categories (mild, moderate and sever). The control group consisted of 108 adults matched to the cases by age and gender. Anthropometric indices and physical activity and a 24 h dietary recall were recorded. All analyses were performed using the SPSS 14. All data presented as means (+/- SD). The mean intake of energy (p = 0.002), protein (p < 0.001), fat (p = 0.007), vitamin C (p = 0.003), vitamin E (p < 0.001), magnesium (p < 0.001) and omega-3 (p < 0.001) was significantly lower in COPD patients compared with controls. The mean BMI of the severe group was significantly lower than the controls (p = 0.016). The mean intake of energy, carbohydrate, fat, vitamin E, magnesium and omega-3 was significantly lower in both case and control groups compared to the RDA (p < 0.001) for all of the mentioned nutrients). Vitamin C intake was lower than RDA in the case (p < 0.001) and also in the control males (p < 0.001). In COPD patients, there is a significant relationship between the stage of COPD and nutrients intake and their BMI.

Circulating visfatin in chronic obstructive pulmonary disease

OBJECTIVE

Malnutrition and continuous systemic inflammation occur frequently in patients with chronic obstructive pulmonary disease (COPD). Visfatin is a new adipokine, which increases in some inflammatory diseases. Its plasma level and relation with nutritional status and inflammation in COPD remain unknown. This study compared visfatin levels, nutritional status, and inflammation markers in patients with COPD and healthy controls.

METHODS

Plasma visfatin, tumor necrosis factor-alpha (TNF-alpha) and C-reactive protein (CRP) were measured in 35 patients with COPD and 28 healthy controls. Body composition was assessed with bioelectrical impedance analysis.

RESULTS

Significantly lower body mass index and percentage of body fat were observed in patients with COPD compared with control subjects. The levels of plasma visfatin were higher in the COPD group compared with healthy controls (2.07 +/- 0.18 versus 1.88 +/- 0.15 ng/mL, P < 0.001). Levels of TNF-alpha and CRP were also significantly higher in patients with COPD compared with controls. Plasma CRP and TNF-alpha were positively correlated with visfatin in the COPD group. No significant correlations were found between visfatin and body mass index or percentage of body fat in both groups.

CONCLUSION

Plasma visfatin levels increased in patients with COPD. This increased adipocytokine was significantly correlated with TNF-alpha and CRP. Visfatin may be a new proinflammatory adipocytokine in this disease.