Impact of chronic obstructive pulmonary disease severity on nutritional status: A longitudinal assessment of malnutrition risk and associated factors

Background: Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition that significantly impacts patients’ nutritional status, particularly as disease severity increases. Malnutrition is common in COPD, leading to worsened functional outcomes, higher healthcare costs, and decreased quality of life. This study aims to assess the prevalence of malnutrition in COPD patients and analyze its association with disease severity and other contributing factors. Materials and Methods: This longitudinal observational study was conducted on 74 COPD patients diagnosed per the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria at Azeezia Medical College, Kollam. Patients over 35 years were included, excluding those with recent exacerbations or severe comorbid conditions. Nutritional assessments were performed using body mass index (BMI), triceps skinfold thickness (TSF), mid-arm circumference (MAC), and mid-arm muscle circumference (MAMC) at baseline and day 21. The Nutritional Risk Screening tool (NRS-2002) was used to evaluate malnutrition risk, with statistical analyses performed to examine the relationship between COPD severity and nutritional decline. Results: Malnutrition prevalence increased with advancing COPD stages, with patients in GOLD stages C and D showing significant reductions in BMI, TSF, MAC, and MAMC. The mean NRS-2002 scores were the highest in advanced stages, indicating elevated malnutrition risk. Comorbidities such as diabetes and lifestyle factors, including smoking and alcohol use, also correlated with worse nutritional status. Conclusion: This study highlights the strong association between COPD severity and nutritional depletion, emphasizing the need for routine nutritional monitoring and targeted interventions in moderate to severe COPD. Integrating nutritional care into COPD management may improve patient outcomes and quality of life, particularly for those in advanced stages.