caa a22 4500 388097302 CHVBK 20180307125307.0 cr unu---uuuuu 161130e199905 xx s 000 0 eng 10.1017/S0029665199000439 doi S0029665199000439 pii (NATIONALLICENCE)cambridge-10.1017/S0029665199000439 Congleton Jo Respiratory Medicine Division, Hammersmith Hospital, Du Cane Road, London W12, UK The pulmonary cachexia syndrome: aspects of energy balance [Elektronische Daten] [Jo Congleton] The present paper reviews current knowledge of the pulmonary cachexia syndrome with reference to chronic obstructive pulmonary disease (COPD). Aspects of incidence, aetiology and management are discussed. Malnutrition occurs in approximately one-quarter to one-third of patients with moderate to severe COPD. Both fat mass and fat-free mass become depleted. Loss of fat-free mass is the more important and appears to be due to a depression of protein synthesis. Weight loss is an independent prognostic indicator of mortality, and is associated with increased morbidity and decreased health-related quality of life. The aetiology of malnutrition in COPD is not well understood. Reduced food intake does not seem to be the primary cause. Resting energy expenditure (REE) is elevated in a proportion of patients and probably contributes to negative energy balance. Measurement of actual REE is helpful when considering the adequacy of nutritional supplementation. The underlying reason for a hypermetabolic state is not known. Although weight-losing COPD patients are not catabolic, nutritional supplementation alone does not appear to reverse the loss of fat-free mass. Strategies involving nutritional supplementation in combination with a second intervention are being explored, and there are some encouraging results using anabolic hormones. Copyright © The Nutrition Society 1999 Pulmonary cachexia syndrome nationallicence Chronic obstructive pulmonary disease nationallicence Energy balance nationallicence Body-weight loss nationallicence Malnutrition nationallicence Proceedings of the Nutrition Society Cambridge University Press 58/2(1999-05), 321-328 0029-6651 58:2<321 1999 58 PNS https://doi.org/10.1017/S0029665199000439 text/html Onlinezugriff via DOI 1 conference jats NATIONALLICENCE 856 40 https://doi.org/10.1017/S0029665199000439 text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- Congleton Jo Respiratory Medicine Division, Hammersmith Hospital, Du Cane Road, London W12, UK NATIONALLICENCE 773 0- Proceedings of the Nutrition Society Cambridge University Press 58/2(1999-05), 321-328 0029-6651 58:2<321 1999 58 PNS CC0 http://creativecommons.org/publicdomain/zero/1.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-cambridge