[Disturbed absorptive function of small intestines in patients with chronic obstructive pulmonary disease].

The study included 93 patients (mean age 56.8+/-7.2) with COPD; 22 presented with grade 1 COPD, 36 and 35 with grade II and 111 COPD respectively. The latter group displayed reduced absorption of fats, proteins, and carbohydrates in the small intestine, the degree of dysfunction increasing with the severity of the disease, degenerative/dystrophic changes in intestinal mucosa, and deterioration of its regenerative potential. The data obtained are interpreted in the context of the relationship between the functional/structural properties of intestinal mucosa and clinical manifestations. The body mass deficit in COPD patients was shown to positively correlate with the reduction of absorption of fats (r=0.55), proteins (r=0. 71), and carbohydrates (r=0.48) in the small intestine.

[Activity of systemic inflammatory reaction in patients with chronic obstructive pulmonary disease in regard to small intestinal absorption function].

AIM: To study the effect of systemic inflammatory reaction in patients with chronic obstructive pulmonary disease (COPD) in association with absorption of the small intestine. MATERIAL AND METHODS: Small intestinal absorption was studied in 93 COPD patients (22, 36 and 35 patients at stage I, II and III, respectively) in a clinically stable stage of the disease and in 35 healthy controls. The absorption was investigated biochemically and with application of radionuclide methods, blood concentration of TNF alpha was measured with enzyme immunoassay. RESULTS: The small intestine of patients with moderate and severe COPD showed subnormal absorption of fats, protein, carbohydrates. With the disease progression, this disorder aggravated. The same trend was seen in relation to TNF alpha concentration. A strong direct correlation was found between a high concentration of TNF alpha and a low absorption of 131I-albumin and fatty acids, this high concentration correlated negatively with low absorption of d-xilose. CONCLUSION: Relationships between inflammation severity and small intestinal absorption of fats, protein, carbohydrates in patients with moderate and severe COPD means loss of essential nutrients, primarily protein and fats. This is important in understanding of pathobiological processes of development of extrapulmonary (intestinal) manifestations in COPD patients.

[Trophologic insufficiency and absorptive function of small intestine in patients with chronic obstructive pulmonary disease].

The study included 93 patients with grade 1-3 chronic obstructive pulmonary disease (COPD) in the stable clinical phase. Absorptive function of the small intestine was evaluated by biochemical methods and with the use of radionuclides; plasma tumour necrosis factor-alpha (TNF-alpha) levels were measured by an enzyme immune-assay. Trophologic status in 44% of the patients with COPD was unaltered whereas 14% had an excessive body weight. Trophologic insufficiency (TI) was diagnosed in 42% of the patients. Severe TI or cachexia occurred in 5.4% of the patients and only in severe COPD. Impaired absorptive function of the small intestine documented in moderately-severe and severe phases of COPD correlated with the severity of the disease. There was close relationship between body weight deficit and reduced protein absorption (r = 0.77 +/- 0.09). The presence and progress of TI correlated with the magnitude of increment of plasma TNF-alpha. The level of TNF-alpha in patients with COPD and cachexia was 7.8 times its normal value. Elevated plasma TNF-alpha concentration positively correlated with body weight deficit (r = 0.77 +/- 0.12). Also, significant direct correlation was found between the rise in TNF-alpha concentration in patients with COPD and TI and enhanced excretion of fat measured by the method of Van de Kamer (r = 0.56 +/- 0.12), albumin (r = 0.78 +/- 0.12), and d-xylose (r = 0.46 +/- 0.12). It is concluded that impaired absorption of fats, proteins, and carbohydrates in the small intestine plays an important role in the mechanisms underlying the development of trophologic insufficiency in patients with moderately-severe and severe phases of COPD.