Body composition in patients with chronic obstructive pulmonary disease: which method to use in clinical practice?

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Data
2006-07-01
Autores
Lerario, Maria Cristina [UNIFESP]
Sachs, Anita [UNIFESP]
Lazaretti-Castro, Marise [UNIFESP]
Saraiva, L. G. [UNIFESP]
Jardim, José Roberto [UNIFESP]
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The objective of the present study was to compare anthropometry with bioelectrical impedance (BIA) in relation to densitometry (dual-energy X-ray absorptiometry; DEXA) as methods of nutritional assessment and body composition in out-patients with chronic pulmonary obstructive disease (COPD). We conducted a cross-sectional clinical study with sixty-one patients with COPD (forty-two men and nineteen women), mean age of 66 center dot 5 (sd 7 center dot 9) years and forced expiratory volume in 1 s of 1 center dot 3 (sd 0 center dot 6) litres (52 center dot 2 (sd 19 center dot 8) % predicted), referred to the Pulmonary Rehabilitation Center. the patients were evaluated regarding nutrition status and body composition as determined by anthropometry, BIA and DEXA. in the results, 34 center dot 4 % showed mild obstruction, 31 center dot 2 %, moderate and 34 center dot 4 %, severe obstruction. According to the BMI (mean 24 center dot 5 (sd 4 center dot 5) kg/m(2)), 45 center dot 9 % of the patients exhibited normal weight, while 27 center dot 9 % were underweight and 26 center dot 2 % were obese. Related to fat-free mass (FFM), anthropometry and BIA compared with DEXA presented high correlations (r 0 center dot 96 and 0 center dot 95 respectively; P < 0 center dot 001) and high reliability between the methods (alpha 0 center dot 98; P < 0 center dot 001). Agreement analysis between the methods shows that anthropometry overestimates (0 center dot 62 (sd of the difference 2 center dot 89) kg) while BIA underestimates FFM (0 center dot 61 (sd of the difference 2 center dot 82) kg) compared with DEXA. We concluded that according to the nutritional diagnosis, half of our population of patients with COPD showed normal weight, while the other half comprised equal parts obese and underweight patients. Body composition estimated by BIA and anthropometry presented good reliability and correlation with DEXA; the three methods presented satisfactory clinical accuracy despite the great disparity of the limits of agreement.
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British Journal of Nutrition. Cambridge: Cambridge Univ Press, v. 96, n. 1, p. 86-92, 2006.