Mini Nutritional Assessment Short-Form as screening tool for osteoporosis in patients with chronic obstructive pulmonary disease

Yukio Fujita ； Masanori Yoshikawa ； Motoo Yamauchi ； Yoshifumi Yamamoto ； Takao Osa ； Kazuhiro Sakaguchi ； Nobuhiro Fujioka ； Takahiro Ibaraki ； Shigeo Muro

《Asia Pacific Journal of Clinical Nutrition》 預刊文章 Pp. 1-15

https://doi.org/10.6133/apjcn.202212/PP.0004

摘要

Background and Objectives: Osteoporosis is a common complication of chronic obstructive pulmonary disease (COPD). It is impractical to measure bone mineral density (BMD) in all patients with COPD. This study aimed to investigate the relationship between Mini Nutritional Assessment Short-Form (MNA-SF), a simple nutritional status questionnaire, and osteoporosis, and to determine whether it can be used as a reliable screening tool for osteoporosis in patients with COPD. Methods and Study Design: Thirty-seven patients with stable COPD were enrolled in this prospective cohort study. Patients with MNA-SF scores ＞11 were defined as well-nourished, and those with scores of ≤11 being at risk for malnutrition. Body composition, BMD, and undercarboxylated osteocalcin (ucOC), a bone metabolism marker, were measured using bioelectrical impedance, dual energy X-ray, and electrochemiluminescence immunoassay, respectively. Results: Seventeen (45.9%) were classified as at risk for malnutrition, and 13 (35.1%) had osteoporosis. Patients at risk for malnutrition had significantly more osteoporosis and higher ucOC values than well-nourished patients (p=0.007, p=0.030, respectively). Patients with osteoporosis also had significantly lower body mass index (BMI) and fat-free mass index than those without osteoporosis (p= 0.007 and p=0.005, respectively), although FEV1 % pred was not significantly different. MNA-SF (cutoff value; 11) had better sensitivity to identify the presence of osteoporosis than BMI (cutoff value; 18.5 kg/m^2) (sensitivity, 0.769; specificity, 0.708; sensitivity, 0.462; specificity, 0.875, respectively). Conclusions: MNA-SF was associated with osteoporosis and bone metabolism markers in patients with COPD. MNA-SF may be a useful screening toolfor osteoporosis in patients with COPD.

關鍵字

chronic obstructive pulmonary disease ； osteoporosis ； Mini Nutritional Assessment Short-Form ； nutritional assessment