title: Oxidative stress and nutritional status in chronic obstructive pulmonary disease.
abstract: BACKGROUND
  Oxidative stress and malnutrition are shown to have pathogenic effect in Chronic Obstructive Pulmonary Disease (COPD).
  
  
  OBJECTIVE
  This study was done to assess the burden of oxidative stress in COPD and to determine its relation to their nutritional status.
  
  
  METHODS
  In this cross-sectional study, 100 COPD cases from emergency and medical ward and meeting inclusion criteria, along with age, sex and occupation (mainly farmers, housewives and drivers) matched 100 controls without COPD and meeting inclusion criteria were enrolled. Oxidative stress was assessed by measuring lipid peroxidation product, Malondialdehyde (MDA) and antioxidants, like Vitamin C, E and Red Blood Cell Catalase (RBCC). Mini Nutritional Assessment (MNA) tool and Body Mass Index (BMI) were used to assess nutritional status.
  
  
  METHODS
  Chi-square test was applied for categorical variable. Student t-test was applied for comparison of means. Analysis of Variance (ANOVA) was applied for comparison between groups followed by Bonferroni post hoc analysis. Pearson correlation method was used for quantitative variables. Statistical significance was defined as p< 0.05 (two tailed).
  
  
  RESULTS
  COPD cases had significantly high MDA level with low level of Vitamin E and catalase as compared to controls (p < 0.001). Most of the COPD cases were underweight (BMI ≤ 18.5 Kg/m(2)) and malnourished (MNA score less than 7). Bonferroni post-hoc analysis, showed significantly high burden of oxidative stress in underweight and malnourished cases as compared to normal weight (p < 0.05) among COPD cases. Highly significant correlation was seen between BMI and plasma MDA level (r = -0.27, p = 0.008) in COPD cases.
  
  
  CONCLUSIONS
  This study shows impaired oxidant/antioxidant balance along with malnutrition and underweight in COPD, which signals for considering antioxidant therapy along with nutritional management.
authors: Lecturer, Department of Biological Sciences, Regional College of Science and Technology , Pokhara, Nepal .
authors: Niraj
authors: N
authors: Dhakal
authors: Professor, Department of Biochemistry, B.P. Koirala Institute of Health Sciences (BPKIHS) , Dharan, Nepal .
authors: Madhab
authors: M
authors: Lamsal
authors: Professor, Department of Biochemistry, BPKIHS , Dharan, Nepal .
authors: Nirmal
authors: N
authors: Baral
authors: Assistant Professor, Department of Biochemistry, B. P. Koirala Institute of Health Sciences (BPKIHS) , Dharan, Nepal .
authors: Shrijana
authors: S
authors: Shrestha
authors: Associate Professor, Department of Pulmonology, Nepal Medical College , Kathmandu, Nepal .
authors: Subodh Sagar
authors: SS
authors: Dhakal
authors: Professor, Department of Internal Medicine, BPKIHS , Dharan, Nepal .
authors: Narendra
authors: N
authors: Bhatta
authors: Lecturer, Department of Biochemistry, Universal College of Medical Sciences , Bhairahawa, Nepal .
authors: Raju Kumar
authors: RK
authors: Dubey
keywords: Body mass index; Chronic obstructive pulmonary disease; Malondialdehyde; Mini nutritional assessment tool; Oxidative stress