Intestinal function is impaired in patients with Chronic Obstructive Pulmonary Disease

被引:26
作者
Kirschner, Sarah K. [1 ]
Deutz, Nicolaas E. P. [1 ]
Jonker, Renate [1 ]
Damink, Steven W. M. Olde [2 ]
Harrykissoon, Rajesh, I [3 ]
Zachria, Anthony J. [3 ]
Dasarathy, Srinivasan [4 ,5 ,6 ]
Engelen, Marielle P. K. J. [1 ]
机构
[1] Texas A&M Univ, Ctr Translat Res Aging & Longev, Dept Hlth & Kinesiol, 675 John Kimbrough Blvd, College Stn, TX 77845 USA
[2] Maastricht Univ, Med Ctr, NUTRIM Sch Nutr & Translat Res Metab, Dept Surg, Maastricht, Netherlands
[3] Baylor Scott & White Med Ctr, Dept Med, Div Pulm Crit Care, College Stn, TX USA
[4] Cleveland Clin, Dept Gastroenterol, Cleveland, OH 44106 USA
[5] Cleveland Clin, Dept Hepatol, Cleveland, OH 44106 USA
[6] Cleveland Clin, Dept Pathobiol, Cleveland, OH 44106 USA
基金
美国国家卫生研究院;
关键词
Comorbidity; Gut dysfunction; Protein digestion and absorption; Stable tracer kinetics; Oral sugar tests; Short-chain fatty acids; GASTROINTESTINAL SYMPTOMS; PROTEIN; PERMEABILITY; COPD; PREVENTION;
D O I
10.1016/j.clnu.2020.10.010
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Background & aims: Gastrointestinal symptoms are prevalent extrapulmonary systemic manifestations of Chronic Obstructive Pulmonary Disease (COPD), but have been rarely studied. We dissected the perturbations in intestinal function in human patients with COPD using comprehensive metabolic and physiological approaches. Methods: In this observational study, small intestinal membrane integrity and active carrier-mediated glucose transport were quantified by sugar permeability test in 21 clinically stable patients with moderate to severe COPD (mean FEV1, 41.2 (3.2) % of predicted) and 16 healthy control subjects. Protein digestion and absorption was analyzed using stable tracer kinetic methods. Plasma acetate, propionate, and butyrate concentrations were measured as markers of intestinal microbial metabolism. Results: Compared with healthy controls, non carrier-mediated permeability was higher (0.062 (95% CI [0.046, 0.078]) vs. 0.037 (95% CI [0.029, 0.045]), P = 0.009) and active glucose transport lower in COPD (31.4 (95% CI [23.4, 39.4])% vs. 48.0 (95% CI [37.8, 58.3])%, P = 0.010). Protein digestion and absorption was lower in COPD (0.647 (95% CI [0.588, 0.705]) vs. 0.823 (95% CI [0.737, 0.909]), P = 0007), and impairment greater in patients with dyspnea (P = 0.038), exacerbations in preceding year (P = 0.052), and reduced transcutaneous oxygen saturation (P = 0.051), and was associated with reduced physical activity score (P = 0.016) and lower quality of life (P = 0.0007). Plasma acetate concentration was reduced in COPD (41.54 (95% CI [35.17, 47.91]) vs. 80.44 (95% CI [54.59, 106.30]) mmol/L, P = 0.001) suggesting perturbed intestinal microbial metabolism. Conclusions: We conclude that intestinal dysfunction is present in COPD, worsens with increasing disease severity, and is associated with reduced quality of life. (c) 2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
引用
收藏
页码:2270 / 2277
页数:8
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