Body composition and resting energy expenditure in elderly mate patients with chronic obstructive pulmonary disease

Study objective: Our study investigates nutritional status, resting energy expenditure (REE) and physical performance in elderly patients with stable COPD to identify any early conditions of hypermetabolism, malnutrition and sarcopenia. Methods: Eighty-six mates (40 stable COPD and 46 healthy subjects) over 65 years old were studied. All subjects underwent spirometry, blood gas analysis and a 6-min walking test (6MWT). Fat-free mass (FFM) and appendicular skeletal muscle mass (ASMM) were measured by dual energy X-ray absorptiometry (DEXA). REE was measured by indirect calorimetry. Results: COPD patients had a lower FFM both expressed in kilograms and after correction for height squared. The prevalence of sarcopenia was higher for COPD subjects (38% vs 31%). REE, both in absolute values and adjusted for FFM was significantly higher in COPD patients. Hypermetabolism was found in 60% of COPD cases and 13.7% (P < 0.01) of healthy subjects. No relationship was found in COPD patients between the measured/predicted REE ratio (REEm/REEp) and FEV1. In the hypermetabotic COPD subgroup, the REEm/REEp ratio correlated with 6MWT. Conclusions: Elderly patients with stable COPD develop an increased REE. This hypermetabotism seems to be independent of the severity of the pulmonary obstruction and to influence the patient's physical performance. (c) 2006 Elsevier Ltd. All rights reserved.