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

• Published in: Asia Pacific Journal of Clinical Nutrition Vol. 32; no. 1; pp. 13 - 18
• Main Authors: Fujita, Yukio, Yoshikawa, Masanori, Yamauchi, Motoo, Yamamoto, Yoshifumi, Osa, Takao, Sakaguchi, Kazuhiro, Fujioka, Nabuhiro, Ibaraki, Takahiro, Muro, Shigeo
• Format: Journal Article
• Language: English
• Published: Clayton, Vic HEC Press 01.03.2023
• Subjects: Aged; Body composition; Body mass index; Bone density; Chronic obstructive pulmonary disease; Clinical medicine; Diagnosis; Diet therapy; Diseases, Obstructive; Evaluation; Fractures; Geriatric Assessment; Humans; Immunoassay; Informed consent; Lungs; Malnutrition; Malnutrition - diagnosis; Malnutrition - etiology; Metabolism; Neuropsychology; Nutrition; Nutrition Assessment; Nutritional Status; Osteoporosis; Osteoporosis - diagnosis; Osteoporosis - etiology; Prospective Studies; Pulmonary Disease, Chronic Obstructive - complications; Questionnaires; Statistical analysis; Treatment; Values; Japan; Mini Nutritional Assessment Short-Form; nutritional assessment; osteoporosis; chronic obstructive pulmonary disease
• ISSN: 0964-7058; 1440-6047
• DOI: 10.6133/apjcn.202303_32(1).0003

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/m2) (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 tool for osteoporosis in patients with COPD.