MUSCLE ENERGY-METABOLISM AND NUTRITIONAL-STATUS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY-DISEASE - A P-31 MAGNETIC-RESONANCE STUDY

We investigated the relationship between nutritional status and muscle energy metabolism during exercise in 18 male patients with chronic obstructive pulmonary disease (COPD) and 15 male control subjects using P-31 nuclear magnetic resonance spectroscopy (P-31-MRS). The patients and control subjects were further categorized as in either a well-nourished (% ideal body weight, % IBW greater than or equal to 90) or malnourished (% IBW < 90) state. Muscle energy metabolism was evaluated by determining the ratios PCr/(PCr + Pi) (PCr, phosphocreatine; Pi, inorganic phosphate), and ATP/(PCr + Pi + ATP). The exercise consisted of repetitive hand grips performed against a load. The work rate was normalized for the individual's lean muscle mass by dividing work performed by the forearm fat-free cross-sectional area, which was calculated using H-1-MRS. The PCr/(PCr + Pi) values during exercise did not correlate with the % IBW in any of the groups of control subjects or COPD patients. Furthermore, the PCr/(PCr + Pi) did not correlate with the normalized work rate in either the well-nourished or malnourished subject groups. However, there were correlations within the groups of control subjects and COPD patients. The PCr/(PCr + Pi) values for the normalized work rate were consistently lower in the COPD patients than in the central subjects. These findings suggest that the altered muscle metabolism in COPD patients is not affected by their nutritional status.