ABSTRACT
Objective To explore the subjective global assessment (SGA) to evaluate the nutritional status of patients with chronic obstructive pulmonary disease(COPD). Methods Patients with stable COPD (n=122) were included and divid?ed into three groups base on their SGA scores:SGA-A (n=21), SGA-B (n=57), SGA-C (n=44). Nutritional status of all pa?tients was assessed by SGA. Anthropometric measurement, biochemical test, pulmonary function test, COPD assessment test (CAT) and shuttle walking test (SWT) were studied between all three groups to search statistical significance and correlation with SGA. Results Body mass index(BMI), arm muscle circumference (AMC) and forced expiratory volume in the first sec?ond%of predicted (FEV1%Pred) were all lower in SGA-B and SGA-C than those in SGA-A(P<0.05),there were no statis?tical differences of these parameters between SGA-B and SGA-C. Triceps skin fold (TSF) was lower in SGA-C than that in SGA-B than that in SGA-A, while CAT score is the reverse order (P<0.05). The walking distance of incremental shuttle walking test (ISWI) and the endurance time of endurance shuttle walking test (ESWI) were lower in SGA-C than that in SGA-A (P<0.05). There were no statistical differences of forced expiratory volume in the first second (FEV1)/forced vital ca?pacity(FVC), biochemical parameters between all three groups. SGA scores correlated positively with CAT and negatively with anthropometric parameters, FEV1%Pred and SWT (P<0.05). However no correlations was deduced between SGA scores with FEV1/FVC and biochemical parameters. Conclusion SGA scores correlated with anthropometric parameters, FEV1%Pred, CAT and SWT. SGA is an effective method to assess the nutritional status in patients with stable COPD.
ABSTRACT
Objective To observe the effects of salmeterol/fluticasone on the bone metabolism and bone density of the patients with moderate COPD and whether the effects is relate with inhaled corticosteroid course. Methods Sixty pa-tients with COPD were divided into 2 groups by random digit table. Patients in experimental group (n=30) were given conven-tional therapy with salmeterol/fluticasone one inhale(bid) for continuously 12 months while patients in control group (N=30) were given conventional therapy without any glucocorticoid.The bone mineral density (BMD) of the femoral triangle in all patients were measured by DXA before therapy, 3 months and 12 months after therapy. At the same time, biochemical indi-cators that are correlated with bone metabolism include bone gla protein (BGP) and alkaline phosphatase (ALP) were mea-sured by radioimmunoassay. Results The BMD, BGP and ALP of patients in experimental group and in control group be-fore therapy, 3 month and 12 month after therapy were compared. There is no significant difference (P>0.05) between these two groups before therapy and after 3 month but significant difference was shown after 9 months (P<0.05). Conclusion Short period inhaling salmeterol/fluticasone in patients with COPD is safe. But long-term inhaling salmeterol/fluticason may lead to decline of the bone density in patients with COPD.