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Prevalence of Malnutrition in Outpatients With Stable Chronic Obstructive Pulmonary Disease
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Carrillo Díaz, R. Castillo Sainz" "autores" => array:2 [ 0 => array:3 [ "preGrado" => "Dra" "nombre" => "T." "apellidos" => "Carrillo Díaz" ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Castillo Sainz" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212906700945?idApp=UINPBA00003Z" "url" => "/15792129/0000004000000006/v1_201305150057/S1579212906700945/v1_201305150057/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Articles</span>" "titulo" => "Prevalence of Malnutrition in Outpatients With Stable Chronic Obstructive Pulmonary Disease" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "250" "paginaFinal" => "258" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J.J. Soler, L. Sánchez, P. Román, M.A. Martínez, M. Perpiñá" "autores" => array:5 [ 0 => array:5 [ "preGrado" => "Dr" "nombre" => "J.J." "apellidos" => "Soler" "email" => array:1 [ 0 => "soler_juacat@gra.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "L." "apellidos" => "Sánchez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "P." "apellidos" => "Román" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 3 => array:3 [ "nombre" => "M.A." "apellidos" => "Martínez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 4 => array:3 [ "nombre" => "M." "apellidos" => "Perpiñá" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Unidad de Neumología, Servicio de Medicina Interna, Hospital General de Requena, Requena, Valencia, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital General de Requena, Requena, Valencia, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Universitari La Fe, Valencia. Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. J.J. Soler Cataluña. Unidad de Neumología. Servicio de Medicina Interna. Hospital General de Requena. Paraje Casablanca, s/n. 46430 Requena. Valencia. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2003-09-12" "fechaAceptado" => "2004-01-28" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec153431" "palabras" => array:3 [ 0 => "Chronic obstructive pulmonary disease (COPD)" 1 => "Malnutrition" 2 => "Anthropometric measures" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec153432" "palabras" => array:3 [ 0 => "Enfermedad pulmonar obstructiva crónica (EPOC)" 1 => "Desnutrición" 2 => "Medidas antropomÉtricas" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To determine the prevalence of malnutrition in outpatients with stable chronic obstructive pulmonary disease (COPD) followed at a respiratory clinic.</p> <span class="elsevierStyleSectionTitle">Material and method</span><p class="elsevierStyleSimplePara elsevierViewall">In this prospective study, we assessed the nutritional status of consecutive outpatients with stable COPD by investigating various anthropometric parameters. Patients were malnourished (low body weight) if their body mass index was within the bottom quartile of a reference population. Muscle mass was determined from the midarm muscle area and if this mass was at or within the bottom quartile, muscle wasting was present. Albumin and transferrin plasma concentrations were used as a measure of visceral protein stores. Fat stores were assessed from body fat and if this value was at or within the bottom quartile, calorific malnutrition was present. All patients underwent arterial blood gas sampling at rest and spirometry.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">A total of 178 patients—one woman (0.6%) and 177 men (99.4%)—were enrolled in the study, with a mean (SD) age of 69 (9) years. We found low body weight in 19.1% of the patients, muscle wasting in 47.2%, visceral protein depletion in 17.4%, and fat depletion in 19.1%. Of the patients with normal weight, 62.9% showed muscle wasting. The proportion of patients with a body mass index or midarm muscle area at or within the bottom quartile increased significantly with increased bronchial obstruction (<span class="elsevierStyleItalic">P</span> <.001 and <span class="elsevierStyleItalic">P</span>=.015, respectively), though 35.7% of the patients showed muscle wasting even when COPD was mild.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Many patients with stable COPD suffer malnutrition. Nutritional state is worse with more severe COPD. Depletion involves both fat stores and muscle and visceral protein stores, but the greatest effect is seen in muscle wasting. A significant number of patients with normal weight also suffer muscle wasting. Although changes in body composition were common in our patients, low body weight was less prevalent than has been reported for populations in countries that are socially and economically similar to Spain.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Determinar la prevalencia de la desnutrición en pacientes con enfermedad pulmonar obstructiva crónica (EPOC) estable, controlados en una consulta especializada de neumología.</p> <span class="elsevierStyleSectionTitle">Material Y Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se realizó un estudio prospectivo y con-secutivo en pacientes con EPOC estable controlados de forma ambulatoria. Para valorar el estado nutricional empleamos diversos parámetros antropomÉtricos. Se definió desnutrición global (bajo peso corporal) como la presencia de un índice de masa corporal inferior al percentil 25 del valor de referencia. Para valorar el compartimiento proteico muscular se determinó el área muscular del brazo y se definió la depleción muscular como un valor de área muscular del brazo igual o inferior al percentil 25. Como valoración de la proteína visceral se midieron las concen-traciones plasmáticas de albúmina y transferrina. El compartimiento graso se estudió mediante la determinación de la grasa corporal total. Un valor de Ésta igual o inferior al percentil 25 se utilizó como criterio de desnutrición calórica. Se realizaron a to-dos los pacientes espirometría y gasometría arterial en reposo.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se incluyó en el estudio a 178 pacientes -una mujer (0,6%) y 177 varones (99,4%)-, con una edad media de 69 ± 9 años. Las prevalencias de bajo peso corporal, desnutrición proteica, muscular o visceral y depleción grasa fueron del 19,1, el 47,2, el 17,4 y el 19,1%, respectivamente. Entre los pacientes con normopeso, el 62,9% presentaba pÉrdida de masa muscular. La proporción de casos con índice de masa corporal igual o menor del percentil 25 o área muscular del brazo igual o inferior al percentil 25 aumentó de forma significativa a medida que empeora-ba el grado de obstrucción bronquial (p < 0,001 y p = 0,015, respectivamente). No obstante, hasta un 35,7% de los pacientes con EPOC leve tambiÉn mostraron depleción proteica muscular.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">La desnutrición en pacientes con EPOC estable es un problema frecuente, que aumenta con la gravedad de la enfermedad. La depleción afecta tanto al compartimiento graso como al proteico muscular y visceral. No obstante, existe un cierto efecto preferencial sobre la pÉrdida de masa muscular. Una proporción significativa de pacientes con normopeso tambiÉn sufre desnutrición proteica muscular. Pese a que las alteraciones en la composición corporal son frecuentes, nuestros resultados reflejan una prevalencia de bajo peso corporal menor que la de diversas series publicadas en países de nuestro entorno social y económico.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:42 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Systemic effects of chronic obstructive pulmonary disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "AGN Agustí" 1 => "A Noguera" 2 => "J Sauleda" 3 => "E Sala" 4 => "J Pons" 5 => "X Busquets" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2003" "volumen" => "21" "paginaInicial" => "347" "paginaFinal" => "360" "link" => array:1 [ 0 => array:2 [ "url" => 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 4 | 8 |
| 2024 October | 31 | 20 | 51 |
| 2024 September | 33 | 18 | 51 |
| 2024 August | 53 | 45 | 98 |
| 2024 July | 32 | 36 | 68 |
| 2024 June | 30 | 31 | 61 |
| 2024 May | 31 | 25 | 56 |
| 2024 April | 14 | 18 | 32 |
| 2024 March | 18 | 17 | 35 |
| 2024 February | 16 | 18 | 34 |
| 2023 March | 4 | 3 | 7 |
| 2023 February | 13 | 17 | 30 |
| 2023 January | 16 | 25 | 41 |
| 2022 December | 15 | 20 | 35 |
| 2022 November | 14 | 20 | 34 |
| 2022 October | 17 | 27 | 44 |
| 2022 September | 17 | 13 | 30 |
| 2022 August | 14 | 29 | 43 |
| 2022 July | 20 | 34 | 54 |
| 2022 June | 14 | 31 | 45 |
| 2022 May | 12 | 34 | 46 |
| 2022 April | 16 | 26 | 42 |
| 2022 March | 17 | 35 | 52 |
| 2022 February | 13 | 25 | 38 |
| 2022 January | 10 | 28 | 38 |
| 2021 December | 12 | 36 | 48 |
| 2021 November | 11 | 33 | 44 |
| 2021 October | 15 | 39 | 54 |
| 2021 September | 19 | 44 | 63 |
| 2021 August | 7 | 29 | 36 |
| 2021 July | 8 | 26 | 34 |
| 2021 June | 12 | 32 | 44 |
| 2021 May | 13 | 17 | 30 |
| 2021 April | 24 | 25 | 49 |
| 2021 March | 22 | 29 | 51 |
| 2021 February | 7 | 10 | 17 |
| 2021 January | 5 | 13 | 18 |
| 2020 December | 5 | 17 | 22 |
| 2020 November | 6 | 8 | 14 |
| 2020 October | 6 | 3 | 9 |
| 2020 September | 3 | 8 | 11 |
| 2020 August | 8 | 5 | 13 |
| 2020 July | 9 | 15 | 24 |
| 2020 June | 8 | 6 | 14 |
| 2020 May | 14 | 15 | 29 |
| 2020 April | 14 | 8 | 22 |
| 2020 March | 11 | 15 | 26 |
| 2020 February | 18 | 13 | 31 |
| 2020 January | 9 | 15 | 24 |
| 2019 December | 14 | 16 | 30 |
| 2019 November | 9 | 11 | 20 |
| 2019 October | 3 | 11 | 14 |
| 2019 September | 10 | 17 | 27 |
| 2019 August | 19 | 11 | 30 |
| 2019 July | 23 | 18 | 41 |
| 2019 June | 4 | 14 | 18 |
| 2019 May | 8 | 18 | 26 |
| 2019 April | 6 | 23 | 29 |
| 2019 March | 7 | 15 | 22 |
| 2019 February | 9 | 24 | 33 |
| 2019 January | 9 | 9 | 18 |
| 2018 December | 12 | 20 | 32 |
| 2018 November | 16 | 7 | 23 |
| 2018 October | 14 | 12 | 26 |
| 2018 September | 8 | 13 | 21 |
| 2018 May | 4 | 0 | 4 |
| 2018 April | 10 | 14 | 24 |
| 2018 March | 6 | 7 | 13 |
| 2018 February | 5 | 10 | 15 |
| 2018 January | 5 | 16 | 21 |
| 2017 December | 5 | 7 | 12 |
| 2017 November | 2 | 18 | 20 |
| 2017 October | 4 | 12 | 16 |
| 2017 September | 3 | 8 | 11 |
| 2017 August | 9 | 12 | 21 |
| 2017 July | 5 | 14 | 19 |
| 2017 June | 7 | 16 | 23 |
| 2017 May | 7 | 13 | 20 |
| 2017 April | 3 | 6 | 9 |
| 2017 March | 3 | 12 | 15 |
| 2017 February | 1 | 2 | 3 |
| 2017 January | 2 | 5 | 7 |
| 2016 December | 3 | 6 | 9 |
| 2016 November | 18 | 9 | 27 |
| 2016 October | 15 | 18 | 33 |
| 2016 September | 13 | 10 | 23 |
| 2016 August | 5 | 3 | 8 |
| 2016 July | 3 | 6 | 9 |
| 2016 March | 2 | 0 | 2 |
| 2015 December | 4 | 0 | 4 |
| 2015 October | 67 | 1 | 68 |
| 2015 September | 56 | 11 | 67 |
| 2015 August | 73 | 18 | 91 |
| 2015 July | 118 | 9 | 127 |
| 2015 June | 63 | 9 | 72 |
| 2015 May | 67 | 16 | 83 |
| 2015 April | 67 | 15 | 82 |
| 2015 March | 68 | 8 | 76 |
| 2015 February | 50 | 6 | 56 |
| 2015 January | 42 | 7 | 49 |
| 2014 December | 47 | 19 | 66 |
| 2014 November | 60 | 10 | 70 |
| 2014 October | 79 | 11 | 90 |
| 2014 September | 53 | 8 | 61 |
| 2014 August | 44 | 10 | 54 |
| 2014 July | 59 | 4 | 63 |
| 2014 June | 66 | 15 | 81 |
| 2014 May | 67 | 8 | 75 |
| 2014 April | 58 | 6 | 64 |
| 2014 March | 78 | 16 | 94 |
| 2014 February | 69 | 6 | 75 |
| 2014 January | 59 | 6 | 65 |
| 2013 December | 71 | 11 | 82 |
| 2013 November | 45 | 9 | 54 |
| 2013 October | 49 | 8 | 57 |
| 2013 September | 52 | 15 | 67 |
| 2013 August | 44 | 11 | 55 |
| 2013 July | 58 | 31 | 89 |
| 2013 June | 51 | 8 | 59 |
| 2013 May | 41 | 7 | 48 |
| 2013 April | 27 | 4 | 31 |
| 2013 March | 10 | 2 | 12 |
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