Investigation of the relationship between nutritional status and body anthropometric measurements and COPD weight of COPD patients attending to Chest Diseases of Dicle University Faculty of Medicine

Aim: COPD is associated with progressive irreversible airflow obstruction, chronic airway inflammation, and persistent respiratory symptoms, as well as airway restriction and extrapulmonary symptoms. In COPD, nutritional deficiencies, respiratory disorders such as hypoxia and hypercapnia, drug therapy and infection may cause metabolic changes and hyper metabolism. Malnutrition and decreased muscle mass cause decreased exercise capacity and worsening of pulmonary function test parameters in COPD patients. Another consequence of malnutrition is respiratory failure with the destruction of skeletal and respiratory muscles. In this study, we aimed to take body anthropometric measurements of COPD patients who applied to our outpatient clinic, to evaluate their nutritional status, and to determine their COPD severity and to examine the relationship between them. Material and Method: In this study, body anthropometric measurements such as height, weight, body mass index, triceps skin fold thickness, calf circumference, neck circumference, waist circumference, and upper middle arm circumference were performed in our COPD patients over 40 years of age who applied to our outpatient clinic between 15.11.2022 and 01.03.2023.Fat mass, FFM, FFMI [(kg/height² (m²)] were calculated with the Tanita BF350 professional body analysis monitor. In order to examine the nutritional status of the patients, the Mini Nutritional Assessment (MNA) form and the Malnutrition Universal Screening Tool (MUST test) were filled in and supplemented with biochemical parameters obtained from the hospital database. The severity of COPD of the patients was determined by the Severity Staging of Airflow Restriction in COPD (Post-bronchodilator FEV1), GOLD staging, CAT score, and mMRC scale. SPSS (Statistical Package for Social Sciences) for Mac version 28.0 was used for statistical data analysis. Numerical variables were expressed as mean and standard deviation, and categorical variables were expressed as numbers and percentages. Whether numerical measurements showed normal distribution or not was determined by Kolmogorov-Smirnov test. Results: A total of 129 COPD patients, 112 (86.8%) men and 17 (13%) women, were studied. The PFT parameters of our patients were FEV1 (lt) average 1.39 lt, FEV1(%pred) average 45%, FVC (lt) average 2.44 lt, FVC (%pred) 62%, and FEV1/FVC average 57%.The average of FEF 25-75 (lt) indicating obstruction in the small airways is 0.70 liters, while the average of FEF 25-75 (pred) is 24%.Correlation analysis was performed between the PFT parameters of the patients and the FFM.A statistically significant positive correlation was found between FFM and FEV1, FVC, FEV1/FVC and FEF 25-75 measurements (p<0.05).A statistically significant negative correlation was found between fat percentage and FVC measurement (p=0.013, r=-0.219).The patients were divided into 2 groups as low and normal in terms of FFMI. Patients were classified as low because they were <15 in women and <16 in men. Patients were compared in groups in terms of PFT parameters. FEV1, FEV1/FVC and FEF 25-75 values were statistically significantly different between the groups (p<0.05).MNA and MUST assessment tests were performed to determine the nutritional status of the patients. PFT parameters of the patients were compared with these tests. A statistically significant difference was found between MUST scale and FEV1(%Pred) and FEF 25-75 (lt) values. (p=0.033),(p=0.034).In addition, a statistically significant difference was found between the MNA test and the FEF 25-75 (lt) value (p=0.017). Conclusion: As a result, it was determined that as the BMI of COPD patients decreased and the FFM and FFMI values decreased, the respiratory function parameters deteriorated. In addition, the severity of COPD increases as the nutritional status of patients worsens. For this reason, it is thought that determining the nutritional status of diagnosed COPD patients in the early period and providing the necessary nutritional support will have a positive effect on morbidity. Keywords: Nutrition, Nutritional status, Pulmonary function tests, lean body mass