Significance of nutritional status in chronic obstructive pulmonary disease: a survey

Introduction: Malnutrition is a common finding in patients with COPD due to overproduction of inflammatory cytokines as well as nutritional deficiencies. Objective: Our primary aim was to assess the combined risk factors of malnutrition in COPD patients. Abnormalities in patients' body mass index were compared with pulmonary function tests and quality of life. Method: We performed a combined nutrition status risk screening using an anonymous questionnaire survey, Malnutrition Universal Screening Tool, and bioelectrical impedance analysis (using InBody 170 and OMRON BF511) in Budapest at the Department of Pulmonary Rehabilitation of the National Institute of Pulmonology between 01 January 2019 and 31 December 2019. Results: Median patient age was 66 (IQR 61-72) years and median BMI was 24.5 (IQR 19.1-29.7) kg/m(2). Of the 110 patients enrolled, 35 (32%) were malnourished and 49 (45%) reported unintended weight loss in the previous 12 months. Patients with malnutrition had significantly lower pulmonary function (FEV(1)ref%: 36 [IQR 29-49]) when compared with patients with a normal BMI (FEV(1)ref%: 46 [IQR 35-52]) and elevated BMI (FEV(1)ref%: 46 [IQR 39-57]), and their quality of life was significantly lower (65.63 vs. 56.59 vs. 47.23; p = 0.045). BMI was correlated with FEV(1)ref% (rho = 0.26; p = 0.007), and the number of exacerbations (rho = 0.37; p = 0.008). Conclusion: Our results showed that COPD patients with malnutrition had worse quality of life, when compared with patients with normal or elevated BMI. Based on these findings, assessment for risk factors of malnutrition and monitoring of the efficiency of nutritional therapy is recommended in patients with COPD.