Background: The association between emphysema and weight los is well known.

Background: The association between emphysema and weight los is well known. bitter [[alpha].sub.1]-antitrypsin deficiency is an important risk factor for the disclosure of emphysema.

subject of attention objective: To study nutritional status and muscle force in patients with severe [[alpha].sub.1]-antitrypsin deficiency and emphysema.

Methods: Fifteen [[alpha].sub.1]-antitrypsin-deficient patients with emphysema (7 men) and 18 healthy sway subjects (9 men) were included in the cogitation Total body protein (TBP) was measured at in vivo neutron activation analysis of nitrogen. Lean material substance mass (LBM) was estimated from measurement of total material substance potassium. In analogy with dead body mass index (BMI), TBP index and LBM index were calculated as TBP/height squared and LBM/height squared, respectively. Respiratory muscle potency was studied by maximal inspiratory urgency (PImax) and maximal expiratory constraining force (PEmax), and skeletal muscle hardness by handgrip test. Plasma albumin, transthyretin, and retinol-binding protein concentrations were analyzed as biochemical markers of nutritional status.

Results: In the [[alpha].sub.1]-antitrypsin-deficient individuals, lung function trial results were consistent with bitter chronic airway obstruction, whereas the healthy check subjects had normal lung function. No significant differences were place in age, body weight, or BMI between the assemblages TBP (p < 0.05), TBP index (p < 0001) LBM index (p < 005) and plasma concentration of transthyretin (p < 001) were significantly lower in the patients than in the superintend subjects. There was a significant correlation between TBP and LBM (p < 0001) and between TBP and corpse weight (p < 0.001). In the male subgroup PImax (p < 005) and PEmax (p < 005) were significantly lower in the patients than in the command subjects. In the female subgroup handgrip impregnability was Significantly lower in the patients than in the hinder subjects (p < 0.05). visible form [i]or[/i] frame weight was significantly correlated with handgrip trial (p < 0.05) in the male patients. In the female patients, carcass weight was significantly correlated with PImax (p < 005) LBM with PEmax (p < 005) and LBM with handgrip example (p < 0.01).

Conclusion: Reduc TBP and plasma transthyretin concentration in [[alpha].sub.1]-antitrypsin-deficient patients with emphysema may indicate early signs of malnutrition.

fundamental note words: [[alpha].sub.1]-antitrypsin deficiency; body protein; emphysema; malnutrition; muscle strength

Abbreviations: BMI = material substance mass index; IVNAA = in vivo neutron activation analysis of nitrogen; LBM = lean corpse mass; PEmax = maximal expiratory pressure; PImax = maximal inspiratory pressure; RBP = retinol-binding protein; RV = residual volume; TBP = total corpse protein; TLC = total lung capacity; TLCO = transfer factor for carbon monoxide; VC = vital capacity

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The association between COPD and weight los is well known. (1) Previous studies (23) have shown that while carcass weight is poorly correlated to lung function impairment, weight los is associated with poor prognosis. Weight los is especially characteristic in patients with COPD with guiltless emphysema (characterized as "pink puffers") while the patients with mainly chronic bronchitis ("blue bloaters") maintain essentially normal dead body weight in late stages of the disease. (4) Several studies (1-4) have shown malnutrition and decreased carcass weight in patients with COPD Muscle wasting is an important issue of malnutrition. (5-8) Reduced respiratory and forearm muscle force have been described as functional correlates to muscle wasting. (56)

In late years, there has been increasing interest in rehabilitation and nutritional support of patients with COPD of that kind interventions have positive effects in succession their quality of life and disease status. (59) Nutritional support is commited in patients suffering from involuntary weight los (10) Hepatic secretory proteins, like as albumin, prealbumin (ie, transthyretin), and retinol-binding protein (RBP) have been considered as markers of visceral protein stores. Changes in the plasma concentration of these proteins may deliberate changes in nutritional status. (111) If malnutrition could be bring to lighted in patients with COPD while they still have normal material substance weight, weight loss might be stoped by nutritional support. Sensitive rules to detect early signs of malnutrition are therefore needed

strait-laced [[alpha].sub.1]-antitrypsin deficiency is a hereditary risk factor for disentanglement of emphysema, especially in smoker (1213) depressed body mass index (BMI) in patients with plain [[alpha].sub.1]-antitrypsin deficiency in dicates poor survival, (14) on the other hand to our knowledge, no studies upon body composition in [[alpha].sub.1]-antitrypsin-deficient patients with emphysema have been published previously. The aim of the not past nor future study was to investigate nutritional status in patients with stern [[alpha].sub.1]-antitrypsin deficiency and emphysema by means of measurement of total body protein (TBP) lean material substance mass (LBM), muscle strength, and biochemical markers of malnutrition.

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