The relationship between nutritional status and body anthropometric measurements with disease severity and exacerbation in bronchiectasis patients

Introduction and Objective: Bronchiectasis is a respiratory disease characterized by permanent dilation of the airways, chronic infections, and inflammation. The disease manifests with frequent exacerbations, significantly reducing the quality of life. Low BMI and malnutrition can lead to a weakened immune system and increased susceptibility to infections. Recurrent infections and inflammations in bronchiectasis patients can worsen the severity of the disease, leading to more frequent exacerbations. On the other hand, adequate nutrition and the preservation of muscle mass can improve patients' quality of life and reduce the severity of the disease, primarily by enhancing the function of respiratory muscles. Early assessment of nutritional status and the provision of appropriate nutritional interventions can improve the overall health status of patients and slow the progression of the disease. In this study, we aimed to examine the effects of body anthropometric measurements and nutritional status on the severity and exacerbation of the disease in bronchiectasis patients. Materials and Methods: A total of 125 patients who presented to the Pulmonology outpatient clinic at Dicle University Faculty of Medicine Hospital between 01.06.2023 and 31.04.2024 with clinical symptoms and suspicion of bronchiectasis on PAAG, confirmed by thoracic CT, and previously diagnosed with bronchiectasis were selected as the study population. The demographic characteristics, height, weight, sputum culture, BMI, body anthropometric measurements, BIA, and SFT parameters of bronchiectasis patients were analyzed. MNA and MUST tests were used to evaluate the nutritional status of the patients, supported by biochemical parameters. Additionally, the BSI was calculated to assess the severity of bronchiectasis. Results: A total of 125 bronchiectasis patients were included in our study. The mean age of the patients was 42.41±18.10 years. Among the participants, 57.6% were women, and 70.4% were non-smokers. When patients were classified according to the MNA test, it was observed that patients at risk of malnutrition had lower respiratory functions and higher disease severity. Negative correlations were found between the nutritional status indicators, such as MNA and albumin levels, and BSI scores, which measure disease severity. Additionally, it was determined that the decrease in FFM and FFMI values increased the severity of the disease. In our study, significant and negative correlations were demonstrated between BSI and SFT parameters in bronchiectasis patients; as BSI scores increased, FEV1 (%), FVC (%), FEV1/FVC, and FEV25-75 values decreased. It was observed that as BSI scores increased, systemic inflammation indicators such as CRP, IgA, WBC, and sedimentation also increased. No significant relationship was found between the frequency of exacerbations and BMI, FFM, and FFMI, but exacerbations were more frequent in patients with dyspnea. Conclusion: Nutritional status and body composition in bronchiectasis patients are closely related to the severity of the disease. Improving nutritional status can enhance the quality of life of patients and slow the progression of the disease. Therefore, regular evaluation of the nutritional status of bronchiectasis patients and the provision of appropriate nutritional interventions are essential. Keywords: Bronchiectasis Severity, Exacerbation, Malnutrition, Fat-Free Mass