[Relation of airway obstruction and respiratory muscle weakness to energy metabolism in pulmonary emphysema].
Resting energy expenditure (REE) was assessed and its relationship to nutritional status, pulmonary function and respiratory muscle function was studied in 25 patients with pulmonary emphysema. The mean value of REE was 1413 +/- 251 Cal and the ratio of REE/REEpred was 1.398 +/- 0.23, suggesting the existence of a hypermetabolic state in these patients. REE/REEpred ratio was inversely correlated with plasma amino acid BCAA/AAA ratio and body muscle mass; and PImax. REE was inversely correlated with FEV1.0%. REE in the patient subgroup with severe hyperinflation (%RV > or = 200) was significantly higher than that in the subgroup with moderate hyperinflation. Malnourished patients showed significantly more severe hyperinflation than well-nourished patients. These findings suggest that augmented REE contributes to malnutrition in patients with emphysema, and that the increase in REE was related to the increase in mechanical work load on the basis of airway obstruction, respiratory muscle weakness and hyperinflation.
Yoneda
T
T
Second Department of Internal Medicine, Nara Medical University, Japan.
Yoshikawa
M
M
Tsukaguchi
K
K
Tokuyama
T
T
Fu
A
A
Tomoda
K
K
Cho
S
S
Narita
N
N
D000368:Aged; D000596:Amino Acids / Q000378:metabolism; D004734:Energy Metabolism; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000503:physiopathology*; D009752:Nutritional Status; D011656:Pulmonary Emphysema / Q000378:metabolism / Q000503:physiopathology*; D012119:Respiration; D012132:Respiratory Muscles / Q000503:physiopathology*
D000596:Amino Acids