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Undernutrition state in patients with chronic obstructive pulmonary disease: A critical appraisal on diagnostics and treatment
Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Karolinska Institutet. (Gunnar Akner)ORCID iD: 0000-0002-1592-8835
Karolinska Institutet.
2016 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 117, 81-91 p.Article in journal (Refereed) Published
Abstract [en]

Undernutrition state’ (UNS) is an ominous condition, in particular when associated with chronic obstructive pulmonary disease (COPD). In this review we discuss pathophysiological mechanisms and how UNS is defined and diagnosed. It seems unlikely that COPD-patients with established UNS have similar potential of reversibility (treatability) upon nutrition interventions as patients at a risk of developing such a condition, i.e. patients with low energy/nutrient intake, since pathophysiological, biochemical and metabolic conditions may differ substantially.

We summarize the results of 7 of 17 published randomized controlled trials of nutritional supplementation in COPD-patients with defined UNS in the latest Cochrane review (2012). We thus excluded 10 of 17 trials included in review (2012), mostly because those studies also included patients with ’risk of’ UNS.

The seven included trials exhibit extensive heterogeneity for all studied variables. Most studies did not show beneficial effects of nutritional supplementation, although some reported minor increase in body weight and physical function of unclear clinical relevance.

In contrast to the Cochrane review we conclude that it is difficult to draw firm conclusions regarding the effect of nutritional supplements in patients with COPD and UNS. Improved knowledge in this area is of utmost importance and some factors which should be considered in future studies are suggested.

Place, publisher, year, edition, pages
2016. Vol. 117, 81-91 p.
Keyword [en]
Chronic obstructive lung disease, COPD, undernutrition state, malnutrition, nutrition supplementation
National Category
Gerontology, specializing in Medical and Health Sciences
Research subject
Natural Science, Medicine; Medicine, Gerontology
Identifiers
URN: urn:nbn:se:lnu:diva-55385DOI: 10.1016/j.rmed.2016.05.023ISI: 000380853700011PubMedID: 27492517OAI: oai:DiVA.org:lnu-55385DiVA: diva2:952484
Available from: 2016-08-14 Created: 2016-08-14 Last updated: 2017-03-23Bibliographically approved

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CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
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