| Objective:Nutritional depletion is prevalent in patients with Chronic Obstructive Pulmonary Disease(COPD).Mixture pattern nutritional depletion is common in these patients,so nutritional depletion is defined as the presence of weight loss and/or body composition abnormalities. Clinical manifestations include the abnormalities of althropometric measure,biochemical and immunological criterion. The measurement of weight alone,however,dose not give the full extent of nutritional depletion in COPD. The evaluation of body composition is necessary for this. Laaban JP et al came up with "Mutiparameter Nutritional Index (MNI)"according to percentage of ideal body weight(%IBW),triceps skinfold thickness(TSF),mid-arm muscle circumference(MAMC),serum albumin(Alb)and pre-albumin(PAlb),which can give the full extent of nutritional depletionin COPD,especially in exacerbation. The reason for nutritional depletion is complex and various,and is not clarified fully so far. We have to accept that COPD is a kind of systemic disease which does not only involve the lung.Alteration in body composition,with reduction in muscle mass is a very important pathological consequence. Furthermore,weight loss and body composition abnormalities are more than merely reflections of disease severity,but also are independent predictors of morbidity and mortality in COPD. Carrying out reasonable nutritional treatment in patients with COPD can improve the nutritional status,in hence,can improve prognosis. In order to find reasonable nutritional treatment,we must master accurately the change and adjustment of organism metabolism in patients with COPD. Thyroid hormones not only influence organism metabolism and oxygen consumption,but also take part in the adjustment of protein biosynthesis,therefore,there may be correlation between thyroid hormones and nutritional status in COPD. Leptin is proteohormone encoded by the ob gene and produced by adiposity. Leptin takes its physiological effect by central and peripheral receptor.It can depress the appetite,reduce energy incept,increase energy expenditure,and restrain adiposity synthesis,in hence,it can regulate body adiposity. One of characteristic of patients with COPD and nutritional depletion is weight loss and adiposity exhaustion. Schols et al showed that cytokine-leptin link in pulmonary cachexia might explain the poor response to nutritional support in some of the cachectic patients with COPDï¼›Plasma leptin is related to proinflammatory status and dietary intake inpatients with COPD. This study assessed the nutritional status of 31 cases with COPD and detected their thyroid hormones,leptin level in order to explore the pathophysiology of nutritional depletion in COPD,and to provide rationale for reasonable nutritional treatment in COPD patients with malnutrition. Methods:We selected 31 cases of COPD,they have no other diseases as can influence organism metabolism and nutritional status. 11 healthy elders served as control subjects. Weight,height,%IBW,TSF,MAMC,CHI,Alb,PAlb,TFR and TLC were measured in all subjects in ordered to assess their nutritional status. 31 patients with COPD were divided into two groups according to MNI, namely, malnourished group(15cases) and non- malnourished group(16 cases). Blood of vein was collected from every subject. We measured the levels of T3, T4, TSH in serum by radio immunoassay, serum leptin were determined by ELISA. Differences among groups were statistically analyzed using analysis of variance,and least significant difference or t' test. The relations between parameters were statistically analyzed using analysis of linear correlation. Data were analyzed using Statistics Analysis System Version 6.12. Results:1.Assessed 31 patients'nutritional status according to %IBW,TSF,MAMC,Alb,TLC respectively,we find 29.03%, 87.1%, 29.03%, 58.06%, 77.42% ofpatients occurred malnutrition,respectively. According to MNI,15 patients occurred malnutrition out of 31. Weight, %IBW, TSE,...
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