[Nutritional changes in patients with advanced chronic obstructive pulmonary disease]

The objective of the study has been to evaluate the nutritional status and anthropometric values, of outpatients with stable and severe chronic obstructive pulmonary disease (COPD), and their correlation with pulmonary data.

During a six months period, 45 patients with advanced COPD and severe obstruction, respiratory forced volume in the first second (FEV1) < 50% of the theoretical range, were prospectively studied. Forced vital capacity (FVC), FEV1, FEV1%, PaO2 and PaCO2, body mass index (BMI), triceps (PCT), biceps (PCB), subscapular (PSE) and abdominal (PA) skinfold thickness, arm muscle circumference (PMB), arm muscle area (MAMA), arm fat area (MAFA), fat/muscle index MAMA/MAFA, % of total fat body and visceral protein (hemoglobin, albumin and transferrin) were assessed.

24 patients (53%) had evident nutritional alterations (overweight or malnutrition). More than the 65% of patients had low values of PCT, muscle/fat index and MAFA. Several nutritional parameters had relationship with pulmonary function test, but the BMI better explained the variability of FEV1% (FEV1% + 26.8 = 0.9* BMI, R2 = 0.22).

The BMI is the nutritional value that better predicts the FEV1% in outpatients will stable and severe COPD. These patients present alterations in anthropometric parameters and an anomalous distribution of body fat, that suggests the possibility of carrying out intervention nutritional studies that allow to improve their pulmonary function.