Nilüfer BAYRAKTAR, İrem EMİNSOY, Görek Aslı DİLEKTAŞLI, Gaye ULUBAY, Öner Füsun EYÜPOĞLU

The effects of cachexia and related components on pulmonary functions in patients with COPD

KOAH’lı hastalarda kaşeksi ve bileşenlerinin solunum fonksiyonları üzerindeki etkisi Malnütrisyon kronik obstrüktif akciğer hastalığı (KOAH) olan hastalarda önemli bir problemdir. Bu hastalarda solunumsal kas kaybı ile solunum fonksiyonlarında kötüleşmeye malnütrisyonun mu yol açtığı yoksa ilerlemiş hastalarda kilo kaybı ve malnütrisyona hipokseminin mi yol açtığı hala net değildir. Bu çalışma, KOAH’lı hastalarda malnütrisyonun solunum fonksiyonlarına etkisini araştırmak amacıyla yapıldı. Bu amaçla 35 KOAH’lı olgu çalışmaya alındı. Olgular beden kitle indeksi (BKİ) değerlerine göre iki gruba ayrıldı (grup 1: Kaşektik, grup 2: Nonkaşektik). Tüm olgulara solunum fonksiyon testleri (SFT), serum tümör nekroz faktörü-alfa (TNF-α) düzeyi, istirahat enerji tüketimi (REE), nütrisyonel parametre ve arter kan gazı ölçümleri yapıldı. Kaşektik hastalarda SFT parametreleri, nonkaşektik olgulara göre daha düşüktü. Serum TNF-α düzeyi ve REE malnütrisyonlu hastalarda malnütrisyonu olmayan hastalara göre daha yüksekti. SFT REE, ve serum TNF-α düzeyi arasında istatistiksel anlamlı korelasyon izlendi. Ayrıca, serum albumin düzeyleri de SFT parametreleri ile koreleydi. Bu çalışma, KOAH’lı hastalarda kaşeksinin SFT üzerindeki olumsuz etkisini ortaya koymuştur. Ayrıca, çalışmamız KOAH’da serum protein düzeyi solunum fonksiyonları ve difüzyon kapasitesini etkileyebildiğini göstermiştir. Çalışmamızın başka bir sonucu da KOAH’lı hastalarda artmış REE ve serum TNF-α düzeyinin solunum iş yükünü artırarak kilo kaybına neden olabileceğidir. Bu hastalarda, esansiyel aminoasitler içeren nütrisyonel desteğin SFT’deki etkisini ortaya koyacak yeni çalışmalara ihtiyaç vardır.

KOAH’lı hastalarda kaşeksi ve bileşenlerinin solunum fonksiyonları üzerindeki etkisi

Malnutrition is an important problem in patients with chronic obstructive pulmonary disease (COPD). It still remains unclear whether malnutrition contributes to poor pulmonary function through a loss of respiratory muscle mass, or if advanced disease and hypoxemia are the causes of weight loss and malnutrition in COPD patients. This study was made to examine the effects of malnutrition on pulmonary function tests (PFTs) in COPD patients. With this purpose 35 stable COPD patients were enrolled in this study. According to their body mass indexes, the subjects were divided in two groups (group 1: cachectic and group 2: non-cachectic). All subjects were performed PFTs, serum tumor necrosis factor-alpha (TNF- α) levels, resting energy expenditure (REE), nutrition parameters, and arterial blood gas tension. PFTs were impaired to a greater degree in cachectic than non-cachectic patients. Serum TNF-α levels and REE were higher in cachectic patients than in non-cachectic patients. Significant correlations were observed among PFTs, REE, and serum TNF-α level. Furthermore there was a significant correlation between serum albumin level and PFTs. This study demonstrated that cachexia had a negative effect on PFTs in patients with COPD. Additionally, our study showed that serum protein levels can affect airway function and diffusing capacity of lungs in COPD. Another result of this study was that; increased REE and serum TNF-α levels could contribute to weight loss in patients with COPD. Further studies are needed to demonstrate the effect of nutritional supplementation containing essential amino acids on PFTs in these patients.

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