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BODY TISSUE TYPE COMPOSITION IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND OBESITY

Ovsyannikov E.S. , Avdeev S.N. , Natarov A.A., Budnevsky A.V. , Shkatova Ya.S.

Background. Chronic obstructive pulmonary disease (COPD) is one of the most widespread diseases worldwide. Evaluation of body composition and nutrition is currently considered to be an important factor in diagnosis, assessment and treatment of COPD. Objective: to describe body composition in COPD patients (in accordance with body weight) and to analyze association between body composition and disease severity (symptoms, spirometry, and systemic inflammation markers). Material and methods. The study included 176 patients with COPD, which were divided into 2 groups. The first group included 88 normal weight patients with COPD: 71 men and 17 women, mean age 62.40 ± 8.83 years. The second group included 88 patients with COPD and obesity: 64 men and 24 women, mean age 62.94 ± 5.96 years. We assessed the severity of symptoms such as dyspnea, sputum production, fatigue. Spirometry, six-minute walk test and analysis of body tissue type composition were performed. Levels of leptin, adiponectin, interleukins-4,6,8,10, interferon-γ, c-reactive protein (CRP), tumor necrosis factor receptor 1 (TNF-R1), tumor necrosis factor receptor 2 (TNF-R2), tumor necrosis factor alpha (TNF-α) were measured in blood serum. Results. In patients with COPD and obesity, a low severity of symptoms (specifically dyspnea, sputum production and fatigue) was observed. Levels of CRP, interferon-γ, TNF-α, TNF-R1, TNF-R2 were significantly higher in obese patients compared with normal weight patients, indicating greater systemic inflammation. Patients with COPD and obesity were significantly higher in % fat while normal weight patients were significantly higher in % water. Waist, hip circumference and their ratio were also significantly higher in patients with COPD and obesity. There was no difference in % of muscle mass. Conclusion. It is necessary to distinguish COPD phenotypes, such as COPD phenotype with normal weight and COPD phenotype with obesity to identify new possible approaches to its assessment and treatment. Further investigations of body tissue type composition are required to determine its role in COPD pathophysiology. Key words: chronic obstructive pulmonary disease, obesity, body composition, interleukins, fat

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