Obstructive Lung Diseases: Airways 3 |

Does Systemic Inflammation Effects Nutritional Status and Severity of COPD? FREE TO VIEW

Randeep Guleria, MD; Sneh Arora, PhD; Guresh Kumar, PhD; Anant Mohan, MD
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All India Institute of Medical Sciences, New Delhi, India

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):850A. doi:10.1016/j.chest.2016.08.950
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: Chronic obstructive pulmonary disease (COPD) is a systemic inflammatory disease. Assessment of inflammatory and nutritional status is important for the management of COPD. We looked for association if any between inflammatory markers and nutritional status with the severity of COPD as assessed by lung functions.

METHODS: 106 stable patients of moderate to very severe COPD were evaluated. Serum CRP, TNF- α, IL-6 and IL-8 levels was assessed. Serum TNF- α, IL-6, IL-8 levels was measured by ELISA method. Serum CRP was assessed by Latex Enhanced Immunoturbidmetric method. Detailed clinical assessment was done in all. Nutritional status (BMI, mid upper arm circumference, skin fold thickness) was determined anthropometrically.

RESULTS: Of 106 patients recruited 23 had moderate (FEV1 62.58±13.01% predicted), 46 severe (FEV1 39.31±5.67 % predicted) and 37 very severe (FEV1 22.48±4.32 %predicted) COPD. Median (range) level of IL-6 in moderate, severe and very severe COPD was 15.96(4.0-122.0), 60.0(4.50-555.0), 38.0(7.61-154.20) pg/ml respectively. Median (range) level of IL-8 in moderate, severe and very severe COPD was 384.0(5.0-.200.0), 532.20(5.0-2000.0) and 836.0(6.56-2648.0) pg/ml respectively. Median (range) level of TNF- α in moderate, severe and very severe COPD was 4.87(0.10-145.08), 16.86(0.30-226.32), 20(0.69-180.0) pg/ml respectively. Median (range) levels of CRP in moderate, severe and very severe COPD was 0.60(0.10-3.30), 0.85(0.10-17.65) and 7.0(0.10-10.0) mg/dl respectively. Mean (± SD) level of BMI in moderate, severe and very severe COPD was 23.27±5.25, 20.81±4.4 and 18.44±5.25 kg/meter2 respectively. Sum of four skin fold thickness and mid upper arm circumference was significantly decreased in the more severe group.

CONCLUSIONS: Patients with very severe COPD had a increased level of CRP, TNF- α, Il-6 and IL-8 level and significantly decreased levels of BMI, MUAC and sum of four skin fold thickness.

CLINICAL IMPLICATIONS: Patients with very severe COPD had a increased levels of inflammatory markers and significantly decreased nutritional status. Systemic inflammation increases as COPD becomes more severe and it affects nutritional status. This may have implication in the treatment and nutritional support should be considered as a part of a holistic COPD management program.

DISCLOSURE: The following authors have nothing to disclose: Randeep Guleria, Sneh Arora, Guresh Kumar, Anant Mohan

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