The Triad of Physiological Challenges: Investigating the Intersection of Sarcopenia, Malnutrition, and Malnutrition-Sarcopenia Syndrome in COPD Patients - A Cross-Sectional Study

Abstract

BACKGROUND One of the most prevalent respiratory disorders in modern society is chronic obstructive pulmonary disease (COPD). Frequent comorbidities in COPD patients are abnormal nutritional status and body composition variations. Malnutrition-sarcopenia syndrome, which occurs when the two conditions – malnutrition and sarcopenia – coexist, raises the risk of death more than either condition alone. The current study sought to determine the prevalence of malnutrition, sarcopenia, and malnutrition-sarcopenia syndrome in COPD patients as well as the association between these diseases and the severity of COPD. METHODS The study was a cross-sectional study conducted on hospitalized COPD patients. The sample size of the study was calculated to be 160. A self-structured questionnaire was used to collect the data, containing sociodemographic characteristics, clinical profiles, anthropometric assessment, and bioimpedance indices. Hand grip was measured by a Hand Dynamometer. Assessment of the risk of malnutrition was performed using the Mini Nutritional Assessment-Short Form questionnaire and was confirmed by GLIM criteria. The COPD assessment test (CAT) tool determined the severity of the condition. For the data analysis, comparisons were made using Student’s t test and Mann–Whitney test in bivariate analysis. Multivariate logistic regression analyses were performed considering the outcomes of COPD patients by CAT scores, prolonged length of stay, and hospital readmission six months after discharge. RESULTS The mean age of the participants was 48±5 years. Approximately 61.9% were found to be sarcopenic. Approximately 45.6% of study subjects had malnutrition. Malnutrition sarcopenia syndrome was diagnosed in 38.1% of patients. The study analysis revealed that COPD patients with malnutrition-sarcopenia syndrome had more than twice the odds of prolonged hospital stay, re-admission within 6 months, and higher CAT scores. CONCLUSION The study revealed a high prevalence of sarcopenia, malnutrition, and malnutrition sarcopenia syndrome in patients with COPD. These conditions were found to be statistically significant with prolonged length of stay, re-admission within 6 months, and CAT scores. The findings highlight the importance of addressing these conditions as part of the management of the patients.