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Weight loss in chronic obstructive pulmonary disease

M F Muers1, J H Green

  • 1Respiratory Unit, Killingbeck Hospital, Leeds, UK.

The European Respiratory Journal
|May 1, 1993
PubMed
Summary

Weight loss in chronic obstructive pulmonary disease (COPD) is common and linked to poor outcomes. Some COPD patients exhibit elevated basal metabolic rates (BMR), suggesting hypermetabolism independent of lung function.

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Area of Science:

  • Pulmonary Medicine
  • Metabolic Research
  • Nutritional Science

Background:

  • Weight loss affects over a third of patients with chronic obstructive pulmonary disease (COPD), serving as a poor prognostic indicator.
  • This weight loss is only weakly correlated with respiratory physiological measures like FEV1 and transfer factor, suggesting independent factors are involved.

Purpose of the Study:

  • To investigate the role of basal metabolic rate (BMR) in weight loss among COPD patients.
  • To explore potential causes of hypermetabolism in COPD and its relationship with nutritional status and muscle loss.

Main Methods:

  • Utilized steady-state, non-invasive calorimetry to measure BMR in COPD patients.
  • Analyzed correlations between BMR, lung function tests, arterial blood gases, and body composition.
  • Reviewed controlled studies on nutritional supplementation in COPD.

Main Results:

  • Approximately 40% of COPD patients showed an elevated BMR (10-20%), indicating true hypermetabolism per kilogram of fat-free mass.
  • Elevated BMR could not be predicted by lung function tests or arterial gases.
  • Muscle loss, affecting both type I and type II fibers, was observed, likely due to reduced calorie intake and disuse atrophy.

Conclusions:

  • Hypermetabolism, potentially influenced by factors beyond increased work of breathing such as cytokines or medications, is present in a significant portion of COPD patients.
  • Nutritional supplementation, requiring an approximately 30% energy increase, may be necessary for substantial weight gain and improved exercise tolerance.
  • Further research is needed to elucidate the determinants of increased BMR in COPD and the long-term prognostic impact of nutritional interventions.

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