Oxidative stress and nutritional status in chronic obstructive pulmonary disease

Niraj Dhakal; Madhab Lamsal; Nirmal Baral; Shrijana Shrestha; Subodh Sagar Dhakal; Narendra Bhatta; Raju Kumar Dubey

doi:10.7860/JCDR/2015/9426.5511

Oxidative stress and nutritional status in chronic obstructive pulmonary disease

J Clin Diagn Res. 2015 Feb;9(2):BC01-4. doi: 10.7860/JCDR/2015/9426.5511. Epub 2015 Feb 1.

Authors

Niraj Dhakal¹, Madhab Lamsal², Nirmal Baral³, Shrijana Shrestha⁴, Subodh Sagar Dhakal⁵, Narendra Bhatta⁶, Raju Kumar Dubey⁷

Affiliations

¹ Lecturer, Department of Biological Sciences, Regional College of Science and Technology , Pokhara, Nepal .
² Professor, Department of Biochemistry, B.P. Koirala Institute of Health Sciences (BPKIHS) , Dharan, Nepal .
³ Professor, Department of Biochemistry, BPKIHS , Dharan, Nepal .
⁴ Assistant Professor, Department of Biochemistry, B. P. Koirala Institute of Health Sciences (BPKIHS) , Dharan, Nepal .
⁵ Associate Professor, Department of Pulmonology, Nepal Medical College , Kathmandu, Nepal .
⁶ Professor, Department of Internal Medicine, BPKIHS , Dharan, Nepal .
⁷ Lecturer, Department of Biochemistry, Universal College of Medical Sciences , Bhairahawa, Nepal .

Abstract

Background: Oxidative stress and malnutrition are shown to have pathogenic effect in Chronic Obstructive Pulmonary Disease (COPD).

Aim: This study was done to assess the burden of oxidative stress in COPD and to determine its relation to their nutritional status.

Materials and methods: In this cross-sectional study, 100 COPD cases from emergency and medical ward and meeting inclusion criteria, along with age, sex and occupation (mainly farmers, housewives and drivers) matched 100 controls without COPD and meeting inclusion criteria were enrolled. Oxidative stress was assessed by measuring lipid peroxidation product, Malondialdehyde (MDA) and antioxidants, like Vitamin C, E and Red Blood Cell Catalase (RBCC). Mini Nutritional Assessment (MNA) tool and Body Mass Index (BMI) were used to assess nutritional status.

Statistical analysis: Chi-square test was applied for categorical variable. Student t-test was applied for comparison of means. Analysis of Variance (ANOVA) was applied for comparison between groups followed by Bonferroni post hoc analysis. Pearson correlation method was used for quantitative variables. Statistical significance was defined as p< 0.05 (two tailed).

Results: COPD cases had significantly high MDA level with low level of Vitamin E and catalase as compared to controls (p < 0.001). Most of the COPD cases were underweight (BMI ≤ 18.5 Kg/m(2)) and malnourished (MNA score less than 7). Bonferroni post-hoc analysis, showed significantly high burden of oxidative stress in underweight and malnourished cases as compared to normal weight (p < 0.05) among COPD cases. Highly significant correlation was seen between BMI and plasma MDA level (r = -0.27, p = 0.008) in COPD cases.

Conclusion: This study shows impaired oxidant/antioxidant balance along with malnutrition and underweight in COPD, which signals for considering antioxidant therapy along with nutritional management.

Keywords: Body mass index; Chronic obstructive pulmonary disease; Malondialdehyde; Mini nutritional assessment tool; Oxidative stress.