Evaluation of nutritional status in patients with chronic obstructive pulmonary disease in Government Dharmapuri Medical College, Dharmapuri

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a major cause of chronic morbidity and mortality throughout the world. It is a preventable and treatable disease with some significant extra pulmonary effects that may contribute to severity in individual patients. It is characterized by airflow limitation that is not fully reversible. Aim of the Study: To determine whether Chronic Obstructive Pulmonary Disease is associated with malnutrition, to determine whether there is a relation between the degree of malnutrition and severity of airflow obstruction and to determine whether the severity of airflow obstruction correlates with biochemical markers of visceral protein stores (Serum albumin and Serum prealbumin). Materials and methods: Out of 102 patients initially enrolled for the study, 50 patients were selected. Others were excluded as per exclusion criteria. The patients were defined as having COPD based on GOLD criteria with spirometer showing, post bronchodilator FEV1 / FVC ratio <0.70. The analysis was restricted to patients in the age group of 40 – 60 years. All the patients chosen were smokers and all the patients were males. For each subject, medical history was obtained and clinical examination was done. All subjects had a baseline blood sugar value and renal function tests. On the study day, height and weight were measured. Results: Of the 50 patients in the study, 12 (24%) had mild airway obstruction, 25 (50%) had moderate airway obstruction, and 13 (26%) had severe airway obstruction. The difference in the degree of airway obstruction among the different age groups was not statistically significant. There was a statistically significant difference between the Serum Prealbumin level and degree of airway obstruction among all three groups. 9 (18%) patients in the study were found to have a Serum albumin level of less than 3.5g%. Of these, 1 patient had moderate airway obstruction and 8 had severe airway obstruction. Conclusion: As the study is designed as a cross sectional study, the present analysis will be unable to elucidate the prognostic indications of the nutritional indices. The patients were on different durations of treatment and different drugs. These may have an effect on the findings of the study. Spirometer is a user dependent method of assessment and may not always accurately assess the degree of airway obstruction.