Mini-Nutritional Assessment Test and Fat-Free-Mass Depletion in Tunisian Chronic Obstructive Pulmonary Disease Patients

Khaldi, Soumaya; Kchaou, Khouloud; Chaker, Asma; Kammoun, Rim; Chakroun, Sahar; Chaieb, Faten; Kaouther, Masmoudi; Ben Khamsa, Saloua

Mini-Nutritional Assessment Test and Fat-Free-Mass Depletion in Tunisian Chronic Obstructive Pulmonary Disease Patients

Document Type : Original Article

Authors

Soumaya khaldi ¹

khouloud kchaou ¹

Asma Chaker ¹

Rim Kammoun ²

Sahar Chakroun ²

Faten Chaieb ³

Masmoudi Kaouther ²

Saloua Ben Khamsa ¹

¹ Department of Pulmonary Function Tests, Abderrahmen Mami Hospital, Ariana, Tunisia

² Department of Physiology and Functional Explorations, Habib Bourguiba University Hospital, Sfax, Tunisia

³ Vascular Exploration Unit, Department of Physiology and Functional Exploration, Farhat Hached Hospital, Sousse, Tunisia

Abstract

Background: Fat-Free Mass (FFM) depletion is one of the systemic manifestations of COPD, causing functional impairment. We aimed to evaluate the relevance of the Mini-Nutritional Assessment (MNA) test in predicting FFM depletion in Tunisian COPD patients and to determine the relationship between nutritional status and disease severity.
Materials and Methods: This was a cross-sectional study of patients with stable COPD. Respiratory function was assessed. The MNA test and the COPD Assessment Test (CAT) questionnaire were also completed. FFM was measured by bioelectrical impedance analysis. Fat-Free Mass Index (FFMI) was calculated according to the following formula: FFM (kg)/height (m)². FFM depletion was defined as a FFMI < 16 kg/m².
Results: The study population consisted of 160 patients with COPD. FFM depletion was higher in patients with more severe COPD. Patients with FFM depletion had a lower MNA score than patients without FFM depletion. The independent predictors of FFM depletion in COPD were MNA (p<0.0001; OR=0.333; CI: 0.2-0.552) and BMI (p<0.0001; OR=0.547; CI: 0.408-0.733). The MNA score was significantly correlated with FFMI, CAT score, and lung function. ROC curve analysis defined a value of 19.25 as the optimal cut-off value of the MNA score to discriminate COPD patients with FFM depletion from those without FFM depletion. By using this value, the sensitivity and specificity of the MNA test for detecting FFM depletion were 90% and 74%, respectively.
Conclusion: Our results suggest that the MNA test, a simple and universally available tool, can predict FFM depletion in COPD.

Keywords

Bioelectrical impedance analysis

COPD

Nutritional status

Respiratory function

Quality of life

Subjects