Undernutrition in Patients with COPD and Its Treatment

nutrient

A large cohort study concerning age-dependent impacts of anthropometric variables on spirometric parameters in nonsmoking healthy adults.

BACKGROUNDS: Although height (H) has been considered the principal anthropometric variable governing lung function, the age-dependent differences in its influences on determining spirometric parameters (SPs) have not been conclusively investigated. Moreover, there has been no study centered on age-dependent effects of other anthropometric variables, including body weight (BW) and body fat mass (BFM) on SPs. In addition, the age-dependent influences of these anthropometric variables are anticipated to differ quantitatively between male and female participants. METHODS: A total of 16,919 nonsmoking healthy Japanese adults (men: 6,116, women: 10,803) were partitioned into six groups stratified by gender and age at intervals of 20-years: young-, middle-, and advanced-age groups of either gender. Using a model in which a SP was described by a logarithmic additive function of age, H, BW, and BFM, we determined the partial regression coefficients of the respective anthropometric variables to predict the reference means of SPs, including FVC, FEV1, FEV1/FVC, PEF, FEF50, and FEF75, in the six groups. RESULTS/DISCUSSION: Although the impact of H on FVC and FEV1 was relatively homogeneous irrespective of gender and age, its homogeneity faded for flow parameters, particularly in the female middle- and advanced-age groups, indicating that the age-dependent contribution of H to SPs was enhanced more in women. The impact of BW on SPs differed depending on age, and this effect was also more conspicuous for female participants. H and BW generally exerted positive effects on SPs, whereas BFM had negative effects. Opposite effects of BW and BFM were observed in the female middle-age group in particular. CONCLUSIONS: The effects of anthropometric variables on spirometric parameters are highly age-dependent, particularly in women, leading to the conclusion that the assumption of age-independent, constant partial regression coefficients of anthropometric variables while predicting the reference mean of a certain spirometric parameter may result in substantial errors

Gender-specific impacts of apnea, age, and BMI on parasympathetic nerve dysfunction during sleep in patients with obstructive sleep apnea.

BACKGROUND: The gender-specific influences of various confounding factors, including apnea, age, BMI, and cigarette consumption, on the function of the parasympathetic nerve system (PNS) during sleep in OSA patients has never been investigated. METHODS: One hundred ninety-seven males and 63 females with OSA were subjected to full PSG examinations including assessment of R-R intervals (RRIs) during an overnight ECG. The PNS-derived modulatory effect on the RRIs and the variability of this effect were quantified during REM and NREM using instantaneous time-frequency analysis with complex demodulation. The spectral domain with the maximum instantaneous amplitude in the high-frequency band between 0.15 and 0.4 Hz was defined as the main HF peak and used as a surrogate marker of PNS discharge. Based on density-spectrum-array maps of the main HF peaks (HF-DSA map), shifts in the central frequency of the main HF peak over time were continuously observed. When the main HF peaks on the HF-DSA maps maintained the same central frequency for more than 20 sec or 5 min, the PNS functions were considered to be "stable" or "very stable", respectively. RESULTS: Apneas enhanced PNS-derived cardiac-modulation during REM in males, but more importantly, they made PNS-function unstable during both REM and NREM in males and during NREM in females. Aging blunted the PNS-derived cardiac-modulation during both REM and NREM regardless of gender, but aging had no impact on the stability of PNS-function. BMI blunted PNS-eliciting cardiac-modulation during REM in males and during NREM in both males and females. BMI made the PNS unstable during REM in females. Neither height nor cigarette consumption influenced any PNS-related parameter. CONCLUSIONS: The PNS-derived cardiac-modulation was generally inhibited by aging and obesity, in which the effect of obesity was gender-specific. The PNS instability at nighttime was mainly induced by apneas but by obesity particularly during REM in females

Age-specific impacts of height (H) on PEF and FEF₅₀ estimated for three different age groups of both men and women.

<p>(A): Partial regression coefficients of Ln(H) for reference means of Ln(PEF) in young-, middle-, and advanced-age groups of either gender. Partial regression coefficients of Ln(H) for ΔLn(PEF) are defined as ΔLn(PEF)/ΔLn(H). (B): Partial regression coefficients of Ln(H) for Ln(FEF₅₀) are defined as ΔLn(FEF₅₀)/ΔLn(H).</p

Demographic, anthropometric, and spirometric characteristics of female participants.

<p>Values are the means ± SD. Symbols are the same as denoted in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0100733#pone-0100733-t001" target="_blank">Table 1</a>. ^*: different from the young-age group (at least p<0.03). ^†: different from the middle-age group (at least p<0.03).</p

Demographic, anthropometric, and spirometric characteristics of male participants.

<p>Values are the means ± SD. BMI: body mass index. %FAT: fat percentage of body mass. BFM: body fat mass calculated from body mass (kg) multiplied by %FAT/100. ^*: significantly different from the young-age group (at least p<0.01). ^†: different from the middle-age group (at least p<0.01).</p