Relation between physical capacity, nutritional status and systemic inflammation in COPD

Background: Decreased physical capacity, weight loss, fat-free mass depletion and systemic inflammation are frequently observed in patients with chronic obstructive pulmonary disease (COPD). Objective: Our aim was to examine relations between physical capacity, nutritional status, systemic inflammation and disease severity in COPD. Method: Forty nine patients with moderate to severe COPD were included in the study. Spirometry was preformed. Physical capacity was determined by a progressive symptom limited cycle ergo meter test, incremental shuttle walking test, 12-minute walk distance and hand grip strength test. Nutritional status was investigated by anthropometric measurements, (weight, height, arm and leg circumferences and skinfold thickness) and bioelectrical impedance assessment was performed. Blood samples were analyzed for C-reactive protein (CRP) and fibrinogen. Result: Working capacity was positively related to forced expiratory volume in 1s (FEV₁) (p<0.001), body mass index and fat free mass index (p=0.01) and negatively related to CRP (p=0.02) and fibrinogen (p=0.03). Incremental shuttle walk test was positively related to FEV₁ (p<0.001) and negatively to CRP (p=0.048). Hand grip strength was positively related to fat free mass index, and arm and leg circumferences. Fifty to 76% of the variation in physical capacity was accounted for when age, gender, FEV₁, fat free mass index and CRP were combined in a multiple regression model. Conclusion: Physical capacity in chronic obstructive pulmonary disease is related to lung function, body composition and systemic inflammation. A depiction of all three aspects of the disease might be important when targeting interventions in chronic obstructive pulmonary disease. Please cite this paper as: Hallin R, Janson C, Arnardottir RH, Olsson R, Emtner M, Branth S, Boman G and Slinde F. Relation between physical capacity, nutritional status and systemic inflammation in COPD.