Study of factors associated with bone health status, physical capacity, and quality of life in patients with chronic obstructive pulmonary disease.

• Main Authors: Yu-Tsen weng, 翁栯涔
• Other Authors: Yi-Chin, Lin
• Format: Others
• Language: zh-TW
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/64205153085431651299

碩士 === 中山醫學大學 === 營養學研究所 === 102 === Chronic obstructive pulmonary disease (COPD) is one of the major causes of morbidity and mortality worldwide. Patients with COPD may have lower level of physical activity due to dyspnea. Systemic inflammation is a common complication in patients with COPD, and the elevation of inflammation markers such as C-reactive protein and interleukin-6 have been known to enhance osteoclastic activity and bone resorption, and to inhibit bone formation, and thus increase the risk for osteoporosis and fracture, and compromise the quality of life. The purposes of this study were to analyze the correlations between bone health measurements, physical capacity, quality of life, inflammation markers and lung function parameters, and to compare the abovementioned indicators in patients with COPD with healthy controls. Thirty patients with moderate to severe COPD and thirty healthy controls were recruited form the outpatient clinic of chest medicine and the health center in Chung Shan Medical University Hospital.The subjects are all males. Data of medical history, quality of life and dietary intake was collected through interview. Parameters of lung function, bone health status and physical capacity were assessed and recorded, and venous blood samples were analyzed for serum levels of markers for bone resorption (cross-linked carboxy-terminal telopeptide of type I collagen, ICTP) and bone formation (osteocalcin, OST), as well as inflammation markers, including IL-6 (interleukin-6) and Hs-CRP(high sensitivity C-reactive protein). The results showed that the measurement of physical capacity (6-minute walking distance, 6MWD) and lung functions in patients with COPD were significantly lower than the healthy controls, and the 6MWD was significantly positively correlated with lung functions in patients with COPD. The total body bone mineral contents (BMC) in patients was significantly lower than the controls, and the serum level of IL-6 in osteoporotic COPD patients was significantly higher than those normal or osteopenic COPD patients. There was a significantly positive correlation between the lung function parameter and BMC at femoral neck in patients with COPD. The scores of quality of life, as assessed by St. George Respiratory Questionnaire (SGRQ) in patients were significantly higher than controls. The intake of milk, vegetables and nuts in patients with COPD was lower than the recommended dietary guideline for adults. The intake of meats was significantly positively correlated with BMC at femoral neck in patients with COPD. In conclusion, patients with COPD appeared to have lower physical capacity, and poorer bone health status and quality of life, and increased inflammation as well. In patients with COPD in the current study, there appeared to be positive correlations between the intake of meats and oils and bone measurements. However, no positive correlation between the intake of dairy products and bone measurements has been observed.