KOAH Hastalarında Beslenme Durumunun Hastalık Şiddetine Etkisi

Abstract

Amaç: Bu çalışmanın amacı, KOAH hastalarının beslenme durumunu değerlendirmek ve hastalık şiddeti ile olan ilişkisini incelemektir. Yöntemler: Bu çalışmaya, 15 Kasım 2022 ile 1 Mart 2023 tarihleri arasında göğüs hastalıkları polikliniğine başvuran ve KOAH tanısı almış 40 yaş üzeri hastalar dâhil edildi. Bu hastalara antropometrik ölçümler ve BİA (Biyoelektrik İmpedans Analizi) uygulandı. Beslenme durumu, MNA(Mini Nutritional Assessment) ve MUST(Malnutrition Universal Screening Tool) kullanılarak değerlendirildi. KOAH’ın şiddeti; bronkodilatör sonrası FEV₁( Zorlu Ekspiratuar Volüm – 1. Saniye), CAT(KOAH Değerlendirme Testi) ve mMRC(Modifiye Medikal Araştırma Konseyi Dispne Skalası) dispne skoru ile belirlendi. Bulgular: Çalışmaya 129 hasta (ortalama yaş: 63,01 ± 10,12 yıl) dâhil edildi. Ortalama beden kitle indeksi (BKİ) 24,95 ± 5,59, ortalama FFMI(Yağsız Vücut Kitle İndeksi) ise 19,01 ± 2,91 idi. Düşük kilolu ve obez gruplar arasında FEV₁/FVC(Birinci saniyedeki zorlu ekspiratuar hacmin (FEV₁), zorlu vital kapasiteye (FVC)) oranlarında anlamlı fark bulundu (p=0,025). FFMI ile FEV₁ (p=0,019), FEV₁/FVC (p=0,018) ve FEF25–75 (p=0,015) arasında istatistiksel olarak anlamlı ilişkiler gözlendi. MNA ve MUST skorları da akciğer fonksiyon parametreleri ile anlamlı şekilde ilişkiliydi. Sonuç: Düşük BKİ ve FFMI,KOAH’ta bozulmuş akciğer fonksiyonlarıyla ilişkilidir. Beslenme durumu, hastalık şiddetiyle yakından bağlantılıdır. BIA dâhil olmak üzere beslenme durumunun erken değerlendirilmesi ve uygun beslenme desteği, solunumsal sonuçların ve genel prognozun iyileştirilmesine katkıda bulunabilir; KOAH yönetiminde dikkate alınmalıdır.

Keywords

• vücut kitle indeksi
• beslenme durumu
• akciğer fonksiyon testleri
• yağsız vücut kütle indeksi

The Impact of Nutritional Status on Disease Severity in COPD Patients

Abstract

Background: Hypoxia and systemic inflammation observed in chronic obstructive pulmonary disease (COPD) may lead to weight loss, muscle atrophy, and malnutrition. Objective: The objective of this study is to evaluate the nutritional status of patients with COPD and to examine its association with disease severity. Methods: Patients over the age of 40 who attended the pulmonary outpatient clinic between November 15, 2022, and March 1, 2023, and were diagnosed with COPD were included in the study. Anthropometric measurements and bioelectrical impedance analyses were performed for these patients.The nutritional status of the patients was assessed using the Mini Nutritional Assessment (MNA) and the Malnutrition Universal Screening Tool (MUST). The severity of COPD was determined by post-bronchodilator FEV₁, the COPD Assessment Test (CAT), and the modified Medical Research Council (mMRC) dyspnea scale. Results: The study included 129 patients (mean age: 63.01 ± 10.12 years). The mean BMI was 24.95 ± 5.59, and FFMI was 19.01 ± 2.91. Significant differences were found in FEV₁/FVC ratios between underweight and obese groups (p=0.025). Statistically significant associations were observed between FFMI and FEV₁ (p=0.019), FEV₁/FVC (p=0.018), and FEF25–75 (p=0.015).MNA and MUST scores were also significantly associated with pulmonary function parameters. Conclusion: Lower BMI and FFMI are associated with impaired lung function in COPD. Nutritional status is closely linked to disease severity. Early evaluation of nutritional status, including BIA, and provision of appropriate nutritional support may contribute to improved respiratory outcomes and overall prognosis, and should be considered in COPD management

Keywords

• body mass index
• Nutritional status
• pulmonary function tests
• fat-free mass index

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