Nutritional status and body composition in female patients with interstitial lung diseases

Abstract

Summary: Background: Patients with interstitial lung diseases (ILD) had a higher risk of malnutrition due to dyspnea and decreased lung function. Objective: We evaluated the differences in clinical and body composition between patients with normal nutrition and malnutrition, as well as the agreement between two methods for malnutrition diagnosis, and the factors associated with malnutrition in a cohort of women with ILD. Methods: We performed a cross-sectional analysis of a cohort of female patients with ILD. Malnutrition was assessed using a 7-points subjective global assessment (SGA) and Global Leadership Initiative on Malnutrition (GLIM). Additionally, body composition measured by dual-energy x-ray absorptiometry and bioimpedance analysis, hand grip strength, pulmonary function tests, risk of fractures and sarcopenia were examined. Factors associated with malnutrition using SGA were assessed using univariate and multivariate logistic regression. Results: We included 50 female patients, 29 (58 %) with hypersensitivity pneumonitis and 21 (42 %) with ILD secondary to autoimmune diseases. All patients were receiving immunosuppressant treatment, and some of them were with corticosteroids or nintedanib. 38 % and 26 % of mild or severe malnutrition was identified. Higher frequency of osteoporosis and sarcopenia was observed in malnutrition patients but no differences in pulmonary function were found. Low Appendicular skeletal muscle mass and SARC-F were associated with malnutrition in multivariate analysis. Conclusions: In ILD patients, malnutrition was present in 64 % using SGA-7 points and 84 % using GLIM criteria. The 7-points SGA tool allows for evaluating the nutritional status of patients with ILD, being a feasible tool to optimize clinical and diagnostic care.

Keywords

• Interstitial lung disease
• Progressive pulmonary fibrosis
• Malnutrition
• Body composition
• Sarcopenia