title: Body composition and micronutrient deficiencies in patients with an acute exacerbation of chronic obstructive pulmonary disease.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is a multisystem disorder. Abnormal body composition (BC) and micronutrient deficiencies (MD) contribute significantly to morbidity associated with acute exacerbations of COPD (AECOPD). COPD is a major health problem in Western Sydney.
  
  
  OBJECTIVE
  To study the pattern of BC and MD in patients admitted with an AECOPD to Western Sydney.
  
  
  METHODS
  The BC and serum levels of selected micronutrients were recorded in prospective, consecutive patients admitted to hospital with AECOPD in Western Sydney.
  
  
  RESULTS
  A total of 94 patients was enrolled, 43% female, and the average age was 69.8 ± 8.2 years (SD). Admission spirometry revealed a mean spirometric ratio of 0.42 ± 0.14 (SD) and a severely reduced mean percentage FEV1of predicted at 29.1% ± 11.6 (SD). A total of 51% of the population was overweight or obese, with an average body mass index of 25.9 ± 7.7 kg/m2(SD). When fat-free mass (FFM) was also considered 23% were cachectic, 9% had muscle atrophy and 6% were semi-starved. Vitamin D deficiency (<50 nmol/L) was present in 53% and vitamin B12 deficiency (<222 pmol/L) was present in 31%. Anaemia was present in 30%, with 38% of these being iron deficient. Living status (alone or with family) was not associated with BC or micronutrient deficiencies (MD). Patients with ≥2 hospital admissions for AECOPD had a significantly lower mean B12 level (280.5 ± 143.0 pmol/L (SD) vs 360.5 ± 198.1 pmol/L (SD) P = 0.042). The malnutrition screening tool, a questionnaire-based assessment of malnutrition used by the local health area did not accurately predict patients with abnormal BC or those with >2 MD.
  
  
  CONCLUSIONS
  In patients admitted with AECOPD, the majority of subjects were overweight or obese, with a low FFM. MD, in particular B12 and vitamin D, were common. Interventional studies addressing BC and MD are required to assess potential improvements in AECOPD-related morbidity and mortality.
authors.affiliation: Department of Respiratory and Sleep Medicine, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia.|Ludwig Engel Centre for Respiratory Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia.|University of Sydney at Westmead Hospital, Sydney, New South Wales, Australia.
authors.forename: Charith
authors.identifier: http://orcid.org/0000-0002-0053-8682
authors.initials: C
authors.lastname: Horadagoda
authors.affiliation: Department of Respiratory and Sleep Medicine, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia.
authors.forename: Timothy
authors.initials: T
authors.lastname: Dinihan
authors.affiliation: Department of Respiratory and Sleep Medicine, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia.|Ludwig Engel Centre for Respiratory Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia.
authors.forename: Mary
authors.initials: M
authors.lastname: Roberts
authors.affiliation: Department of Respiratory and Sleep Medicine, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia.|Ludwig Engel Centre for Respiratory Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia.|University of Sydney at Westmead Hospital, Sydney, New South Wales, Australia.
authors.forename: Kristina
authors.initials: K
authors.lastname: Kairaitis
mesh_terms: D000208:Acute Disease; D000368:Aged; D001361:Avitaminosis / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D001823:Body Composition / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage / Q000097:blood*; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*
chemical_list: D018977:Micronutrients
keywords: 
  COPD; body composition; nutrition; vitamin B12; vitamin D