Body composition and micronutrient deficiencies in patients with an acute exacerbation of chronic obstructive pulmonary disease

Horadagoda, Charith; Dinihan, Timothy; Roberts, Mary M.; Kairaitis, Kristina

doi:10.1111/imj.13453

Cited by 25 publications

(19 citation statements)

References 47 publications

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“…Marinho et al (2012) verified muscle depletion occurrence in 20% of COPD individuals and highlighted the fact that subjects with normal BMI presented FFMI decrease. In Horadagoda, Dinihan, Roberts, and Kairaitis (2017), the majority of COPD subjects with acute exacerbation were overweight or obese, and they even had low FFMI. According to Vestbo et al (2006), a FFMI decrease in COPD individuals was associated to airflow obstruction severity level, attesting the inflammatory behaviour and progression of this disease to its systemic repercussions (Vestbo , 2006).…”

Section: Discussionmentioning

confidence: 99%

Inspiratory muscle strength, diaphragmatic mobility, and body composition in chronic obstructive pulmonary disease

Souza

Cardim

Maia

et al. 2019

Physiotherapy Res Intl

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Background and purpose Chronic obstructive pulmonary disease (COPD) is a systemic inflammatory disease that can cause repercussions on respiratory muscles and body composition. The aim of the current study was to evaluate inspiratory muscle strength, diaphragmatic mobility, and body composition in COPD subjects and to correlate these variables. Methods This was a cross‐sectional study performed with 21 COPD patients. Inspiratory muscle strength (manovacuometry), pulmonary function test (forced vital capacity [FVC], forced expiratory volume in 1 s [FEV1], and FEV1/FVC ratio), diaphragmatic mobility (ultrasonography), and body composition (bioelectrical impedance analysis) were examined. Results COPD individuals in Stages II (28.9%), III (52%), and IV (19%) according to Global Initiative for Chronic Obstructive Disease were recruited, 61.9% of which were men. Inspiratory muscle weakness was found in 47.6% of subjects, who presented a lower fat‐free mass percentage (p = 0.017) and smaller fat‐free mass index (p = 0.001) and greater fat mass percentage (p = 0.029) and less diaphragmatic mobility (p = 0.007) compared with the nonrespiratory weakness group. Maximal inspiratory pressure exhibited a moderately positive relationship to the fat‐free mass index (r = 0.767, p < 0.001) and a weak positive relationship to diaphragmatic mobility (r = 0.496, p = 0.022). Conclusion Our study showed a high prevalence of inspiratory muscle weakness based on the severity of airway obstruction and on the presence of muscular depletion. The evaluation of body composition detected important changes. It also demonstrated that not only muscular weakness was present in these patients but also this had repercussions on the mobility of the diaphragm muscle.

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Section: Discussionmentioning

confidence: 99%

Inspiratory muscle strength, diaphragmatic mobility, and body composition in chronic obstructive pulmonary disease

Souza

Cardim

Maia

et al. 2019

Physiotherapy Res Intl

View full text Add to dashboard Cite

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“…However, next to disease severity, Collins et al recently highlighted in a UK COPD population the importance of deprivation on malnutrition risk [125]. An Australian study reported, next to low muscle mass, a high prevalence of deficiencies in vitamin D, vitamin B12 and iron in patients with COPD hospitalized with an acute exacerbation [126]. A Dutch study investigating patients eligible for PR reported that vitamin D and calcium intake were below the recommended levels in more than 75% of patients, whereas vitamin A, C and E intakes were below the recommended levels in over one-third of patients [127].…”

Section: Dietary Insufficienciesmentioning

confidence: 99%

Cognitive impairment in chronic obstructive pulmonary disease: disease burden, determinants and possible future interventions

Beers

Janssen

Gosker

et al. 2018

Expert Review of Respiratory Medicine

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Introduction: Cognitive impairment (CI) is an important but an under-recognized extra-pulmonary feature of chronic obstructive pulmonary disease (COPD). It is related to the burden of disability, worse health outcomes, and impaired self-management. Areas covered: CI includes deterioration of a wide range of cognitive functions, such as memory and various executive functions. Risk of hospitalization might be higher in patients with COPD compared to those without, with CI negatively impacting the wellbeing of patients with COPD. Disease-specific factors such as hypoxemia and inflammation, lifestyle factors such as dietary insufficiencies and lack of physical activity, and comorbidities such as obstructive sleep apnea and depression are likely to synergistically contribute to the development of CI in COPD. Tailored interventions can possibly improve CI in COPD, but this needs further investigation. Expert commentary: Further research is warranted involving the optimization of neuropsychological testing for screening and outcome assessment, longitudinal studies to investigate the development of CI in COPD over time, and randomized clinical trials to test the feasibility and efficacy of promising interventions.

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“…Moreover, alterations in the gut were reported in those patients: ischemia of the intestinal mucosa may lead to an increased gut permeability and bacterial translocation [121]. In COPD patients, micronutrient deficiencies are also common; in particular, for vitamin D, vitamin B12, and iron [122][123][124].…”

Section: Discussionmentioning

confidence: 99%

The Use of Proton Pump Inhibitors May Increase Symptoms of Muscle Function Loss in Patients with Chronic Illnesses

Vinke

Wesselink

Orten-Luiten

et al. 2020

IJMS

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Long-term use of proton pump inhibitors (PPIs) is common in patients with muscle wasting-related chronic diseases. We explored the hypothesis that the use of PPIs may contribute to a reduction in muscle mass and function in these patients. Literature indicates that a PPI-induced reduction in acidity of the gastrointestinal tract can decrease the absorption of, amongst others, magnesium. Low levels of magnesium are associated with impaired muscle function. This unwanted side-effect of PPIs on muscle function has been described in different disease backgrounds. Furthermore, magnesium is necessary for activation of vitamin D. Low vitamin D and magnesium levels together can lead to increased inflammation involved in muscle wasting. In addition, PPI use has been described to alter the microbiota’s composition in the gut, which might lead to increased inflammation. However, PPIs are often provided together with nonsteroidal anti-inflammatory drugs (NSAIDs), which are anti-inflammatory. In the presence of obesity, additional mechanisms could further contribute to muscle alterations. In conclusion, use of PPIs has been reported to contribute to muscle function loss. Whether this will add to the risk factor for development of muscle function loss in patients with chronic disease needs further investigation.

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Body composition and micronutrient deficiencies in patients with an acute exacerbation of chronic obstructive pulmonary disease

Abstract: In patients admitted with AECOPD, the majority of subjects were overweight or obese, with a low FFM. MD, in particular B12 and vitamin D, were common. Interventional studies addressing BC and MD are required to assess potential improvements in AECOPD-related morbidity and mortality.

Cited by 25 publications

References 47 publications

Inspiratory muscle strength, diaphragmatic mobility, and body composition in chronic obstructive pulmonary disease

Inspiratory muscle strength, diaphragmatic mobility, and body composition in chronic obstructive pulmonary disease

Cognitive impairment in chronic obstructive pulmonary disease: disease burden, determinants and possible future interventions

The Use of Proton Pump Inhibitors May Increase Symptoms of Muscle Function Loss in Patients with Chronic Illnesses

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