Undernutrition in Patients with COPD and Its Treatment
Abstract
:1. Introduction
2. State of Undernutrition in COPD Patients
3. Causes of Undernutrition in COPD Patients
4. Adipokines and Hormones Affecting the Nutritional Status in COPD
Cytokines, Adipokines and Hormones | Primary Source | Functions | Changes in Blood Levels in COPD Patients | References |
---|---|---|---|---|
Adiponectin | Adipocytes | Insulin sensitizer, suppress inflammation | ↑ compared to healthy smokers and nonsmkers; correlated with the residual volume, blood TNF-α levels and mortality; inversely correlated with the predicted %FEV1; ↑ during acute exacerbations | [30,31,32,33,34] |
Leptin | Adipocytes, bronchial epithelial cells, alveolar type II pneumocytes, lung macrophages | Appetite control, promote inflammation; regulate hematopoiesis, angiogenesis, wound healing | ↓ in COPD patients with low BMI compared to COPD patients with normal and high BMI and healthy control; ↑ and correlated with TNF-α during acute exacerbation; not correlated with TNF-α in stable COPD patients; plasma and sputum leptin levels are inversely correlated | [23,24,25,29] |
Resistin | Peripheral blood mononuclear cells, adipocytes | Promote insulin resistance and inflammation through IL-6 and TNF-α production | Inversely correlated with FEV1% predicted | [35] |
TNF-α | Stromal vascular fraction cells, adipocytes, monocytes | Promote inflammation; antagonize insulin signaling | ↑ compared to healthy control; ↑ production from the peripheral blood monocytes in lean COPD patients | [13,14,15] |
IL-6 | Adipocytes, atromal vascular fraction cells, liver, muscle | Promote inflammation; appetite loss | ↑ compared to healthy control | [14] |
Ghrelin | X/A-like cells | Stimulate appetite and GH release | ↑ in underweight patients compared with normal weight patients and healthy control subjects; positively correlated with residual lung volume; inversely correlated with FEV1% predicted | [36] |
5. Nutritional Supplement Therapy for COPD Patients
6. High-Calorie Nutrition Therapy for COPD
Nutrients | Effect on FEV1 | Other Effects | Results of Meta-Analysis | References |
---|---|---|---|---|
Liquid prepared supplement | No change | Body weight, FFMI, 6MWD ↑; SGRQ improved | Positive | [6,49] |
Fruits and vegetable | No change (12 weeks) Improve (3 years) | IL-8, TNF-α, CRP → | Not done | [54,55] |
Vitamin E | No data | Risk of COPD ↓ | Not done | [56] |
Vitamin D | No change (1 year) | QOL, mortality rate, acute exacerbation rate → | Not done | [57] |
Creatine | No data | 6MWD, shuttle walk test, SGRQ, upper and lower limb strength → | Negative | [58,59,60,61] |
Glutamine | No data | Lactate threshold, VO2 peak →; IL-6, IL-8, TNF-α → in exacerbated patients receiving mechanical ventilation | Not done | [62,63] |
l-carnitine | No data | 6MWD, inspiratory muscle strength ↑; blood lactate concentration after exercise ↓ | Not done | [64] |
7. Nutritional Supplement Therapy Other Than High-Calorie Nutrition Therapy: Intake of Fruits and Vegetables
8. Intake of Vitamins
9. Creatine Intake
10. Intake of Other Nutrients
11. Conclusions
Conflict of Interest
References
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Itoh, M.; Tsuji, T.; Nemoto, K.; Nakamura, H.; Aoshiba, K. Undernutrition in Patients with COPD and Its Treatment. Nutrients 2013, 5, 1316-1335. https://doi.org/10.3390/nu5041316
Itoh M, Tsuji T, Nemoto K, Nakamura H, Aoshiba K. Undernutrition in Patients with COPD and Its Treatment. Nutrients. 2013; 5(4):1316-1335. https://doi.org/10.3390/nu5041316
Chicago/Turabian StyleItoh, Masayuki, Takao Tsuji, Kenji Nemoto, Hiroyuki Nakamura, and Kazutetsu Aoshiba. 2013. "Undernutrition in Patients with COPD and Its Treatment" Nutrients 5, no. 4: 1316-1335. https://doi.org/10.3390/nu5041316