Murat ÖGETÜRK, Canan KAÇAR, Gamze KIRKIL, Teyfik TURGUT, M. Hamdi MUZ, Figen DEVECİ, Tuncer TUĞ

KOAH olgularında beslenme durumu, solunum fonksiyonları ve egzersiz performansı

Çalışmamızda akut ve stabil dönemdeki KOAH’lı olgularda beslenme durumunun değerlendirilmesi ve beslenme ile ilgili parametreler ile akciğer fonksiyonları, egzersiz performansı ve genel sağlık durumu arasındaki ilişkinin araştırılması amaçlanmıştır. Kronik obstrüktif akciğer hastalığı (KOAH) tanısı konulan 10 atak (grup 1), 14 stabil (grup 2) olgu ile 10 sağlıklı kontrol olgusu (grup 3) çalışmaya alınarak antropometrik ölçümleri ile birlikte serum albumin, transferrin, tümörnekroz faktörü-alfa (TNF-alfa) değerleri, yağsız vücut kütlesi (YVK) ölçümleri yapıldı. Altı dakika yürüme testi (dyt) ve “St. George’s Respiratory Questionnaire (SGRQ)” solunum anketi uygulandı. Beden kitle indeksi (BKİ) grup 1 ve grup 2’de grup 3’e göre anlamlı derecede düşük (sırasıyla; p= 0.023, p= 0.008), serum albumin düzeyleri grup 1’de grup 2 ve grup3’e göre anlamlı derecede düşük (sırasıyla; p< 0.001, p= 0.001), serum transferrin düzeyleri ise grup 1’de grup 3’e göre anlamlı derecede düşüktü (p= 0.015). TNF-alfa seviyeleri grup 1’de grup 2’ye göre (p= 0.002), grup 2’de grup 3’e göre (p=0.001) anlamlı derecede yüksek, YVK grup 1’ de grup 2’ye göre (p= 0.003), grup 2’de grup 3’e göre (p< 0.001) anlamlı derecede düşük bulundu. Altı dyt mesafesi ataktaki olgularda 225.80 ± 40.35 m iken, stabil olgularda 405.16 ± 95.51 m olarakbulundu (p< 0.001). YVK ile BKİ ve 6 dyt arasında (sırasıyla p= 0.006, r= 0.481 ve p< 0.001, r= 0.830) ve serum albumin değeri ile 6 dyt arasında pozitif (p< 0.001, r= 0.850) ilişki, TNF-alfa ile 6 dyt arasında negatif (p< 0.001, r= -0.745) ilişki bulundu. Antropometrik ölçümlerde gruplar arasında istatistiksel fark saptanmadı. Grup 1’de günlük yaşam ve toplam skor grup2’ye göre anlamlı olarak yüksekti (p= 0.009, p= 0.013). Sonuç olarak KOAH’lı olgularda andropometrik ölçümlerdedeğişiklikler saptanmamasına rağmen beslenme bozukluğu olduğu görüldü. Ayrıca, beslenme parametreleri ile efor kapasitesiarasında bir ilişki olduğu saptandı.

Nutritional status, pulmonary functions, and exercise performance in COPD cases

The aim of this study was evaluation of nutritional status in attack and stable chronic obstructive pulmonary disease (COPD) cases, and investigating the relation between nutrition parameters and pulmonary functions, exercise performance and general healthy status. Anthropometric measures of 10 cases with attack (group 1), 14 stabilized COPD cases (group2) and 10 control cases (group 3) were evaluated by measuring serum albumin, transferrin, tumor necrosis factor-alpha(TNF-alpha) levels, and fat-free mass (FFM) levels. Six minutes walking test (mwt) and SGRQ questionnaire were performed. Body mass index (BMI) of group 1 and 2 were significantly lower than group 3 (p= 0.023, p= 0.008, respectively). Albumin levels were significantly lower in group 1 than group 2 (p< 0.001) and 3 (p= 0.001). Levels of transferrin were significantly lower in group 1 compared with group 3 (p= 0.015). TNF-alpha levels were significantly high in group 1 compared with group 2 (p= 0.002), and high in group 2 compared with group 3 (p= 0.001). FFM was significantly low in group 1 compared with group 2 (p= 0.003), and low in group 2 compared with group 3 (p< 0.001). Mean distance of 6 mwt was 225.80± 40.35 m in group 1, it was 405.16 ± 95.51 m in group 2 (p< 0.001). A positive relation was seen between FFM and BMI,6 mwt (p= 0.006, r= 0.481 ve p< 0.001, r= 0.830, respectively), between albumin levels and 6 mwt (p< 0.001, r= 0.850). Anegative correlation was observed between TNF-alpha and 6 mwt (p< 0.001, r= -0.745). There was no statistical difference inantropometric measures between groups. Total score and daily life were statistically high in group 1 than group 2 (p=0.009, p= 0.013). Although no changes was seen in antropometric measures of COPD cases, a nutritional defect was seenand a significant relation was observed between nutrition parameters and effort capacity.

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