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Undernutrition state in patients with chronic obstructive pulmonary disease: A critical appraisal on diagnostics and treatment
Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO). Karolinska Institutet. (Gunnar Akner)ORCID-id: 0000-0002-1592-8835
Karolinska Institutet.
2016 (Engelska)Ingår i: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 117, s. 81-91Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Undernutrition state’ (UNS) is an ominous condition, in particular when associated with chronic obstructive pulmonary disease (COPD). In this review we discuss pathophysiological mechanisms and how UNS is defined and diagnosed. It seems unlikely that COPD-patients with established UNS have similar potential of reversibility (treatability) upon nutrition interventions as patients at a risk of developing such a condition, i.e. patients with low energy/nutrient intake, since pathophysiological, biochemical and metabolic conditions may differ substantially.

We summarize the results of 7 of 17 published randomized controlled trials of nutritional supplementation in COPD-patients with defined UNS in the latest Cochrane review (2012). We thus excluded 10 of 17 trials included in review (2012), mostly because those studies also included patients with ’risk of’ UNS.

The seven included trials exhibit extensive heterogeneity for all studied variables. Most studies did not show beneficial effects of nutritional supplementation, although some reported minor increase in body weight and physical function of unclear clinical relevance.

In contrast to the Cochrane review we conclude that it is difficult to draw firm conclusions regarding the effect of nutritional supplements in patients with COPD and UNS. Improved knowledge in this area is of utmost importance and some factors which should be considered in future studies are suggested.

Ort, förlag, år, upplaga, sidor
2016. Vol. 117, s. 81-91
Nyckelord [en]
Chronic obstructive lung disease, COPD, undernutrition state, malnutrition, nutrition supplementation
Nationell ämneskategori
Gerontologi, medicinsk/hälsovetenskaplig inriktning
Forskningsämne
Naturvetenskap, Medicin; Medicin, Gerontologi
Identifikatorer
URN: urn:nbn:se:lnu:diva-55385DOI: 10.1016/j.rmed.2016.05.023ISI: 000380853700011PubMedID: 27492517Scopus ID: 2-s2.0-84973927966OAI: oai:DiVA.org:lnu-55385DiVA, id: diva2:952484
Tillgänglig från: 2016-08-14 Skapad: 2016-08-14 Senast uppdaterad: 2020-01-23Bibliografiskt granskad

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Akner, Gunnar
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Institutionen för medicin och optometri (MEO)
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Respiratory Medicine
Gerontologi, medicinsk/hälsovetenskaplig inriktning

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