Medical Journal of Dr. D.Y. Patil University (Jan 2016)
Correlating nutritional status with severity of chronic obstructive pulmonary disease in adult females
Abstract
Context: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Recent studies report increased the prevalence of COPD among adult females and nutrition is an important prognostic marker in COPD. Nutrition in Indian females is already a concern, further compromised by increasing the prevalence of COPD. Aims: A study correlation of six selected nutritional parameters: Body mass index, waist-hip ratio, waist-height ratio, serum albumin, hemoglobin, and Mini Nutritional Assessment (MNA) score with the severity of COPD (Global Initiative for Obstructive Lung Diseases [GOLD] categorization) in adult female patients. Settings and Design: A cross-sectional analytical study including all adult female patients diagnosed with COPD based on spirometry, attending pulmonary medicine outpatient department of a medical college between January and June 2014. Patients with pulmonary tuberculosis, acute exacerbations of COPD, and those unwilling to participate were excluded from the study. Subjects and Methods: A total of 100 patients were studied with a detailed history, physical examination, spirometry, anthropometric measurements, laboratory parameters of nutrition, and MNA questionnaire. Statistical Analysis Used: SPSS 14.01 version (IBM analytics) with Pearson's correlation coefficient and one-way analysis of variance (ANOVA) as tests of significance. Results: The study revealed that proportion of adult female COPD patients with GOLD categorization is 7% GOLD1, 40% GOLD 2, 42% GOLD 3, and 11% GOLD 4. Pearson's correlation coefficients calculated for the severity of COPD with six selected nutritional parameters showed statistically significant correlation with MNA score (correlation coefficient = −0.253, P< 0.01) and waist-height ratio. Mean MNA score in GOLD four patients (18.72) was significantly lower than that in GOLD 1 patients (22.14). MNA score decreases toward malnutrition as severity of COPD increases which is statistically significant (F = 2.353, df = 3, P< 0.05) using ANOVA. Similarly, waist-height ratio also decreased significantly with increasing severity of COPD (F = 2.582, df = 3, P< 0.05). Conclusions: The study concludes that malnutrition increases the severity of COPD. Further, it also concluded that MNA score and waist-height ratio correlate better with the severity of COPD than other nutritional parameters.
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