Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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Polyunsaturated fatty acids, lung function, and health-related quality of life in patients with chronic obstructive pulmonary disease

  • Choi, Hyunji (Department of Laboratory Medicine, Kosin University Gospel Hospital) ;
  • Kim, Taeyun (Division of Pulmonology, Department of Internal Medicine, Kosin University Gospel Hospital)
  • Received : 2020.02.17
  • Accepted : 2020.03.26
  • Published : 2020.07.31
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Abstract

Background: Dietary polyunsaturated fatty acids (PUFA) are thought to modify systemic inflammation. The present study aimed to evaluate the relationship between PUFA intake, lung function, and health-related quality of life (HRQoL) in patients with chronic obstructive pulmonary disease (COPD). Methods: In this study, we used the dataset of 6th Korea National Health and Nutrition Examination Survey, in which, a total of 22,948 individuals including 573 participants with a high probability of developing COPD were enrolled. Participants with missing data for the investigated variables were excluded. Linear regression analyses were used to evaluate the association between PUFA intake (omega-3 [N3], omega-6 [N6], and total) with lung function, and HRQoL. HRQoL was determined according to the European Quality of Life-5 Dimensions (EQ-5D). Subgroup analysis of older patients was performed. Age, sex, body mass index, smoking, alcohol, education, residence, total calorie intake, and predicted FEV1% were adjusted in all analyses. Results: Although lung function was not associated with PUFA intake, EQ-5D index was remarkably associated with N3, N6, and total PUFA intake in a dose-dependent manner. This association was more pronounced in elderly COPD patients. Mean levels of N3, N6, and total PUFA intake were significantly higher in patients having better HRQoL with respect to mobility, self-care, and usual activities. Conclusion: Our results suggest that N3, N6, and total PUFA intake are associated with HRQoL in COPD patients. This association may be attributed to mobility, self-care, and usual activities. Further longitudinal study is required to clarify this relationship.

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References

  1. Viegi G, Pistelli F, Sherrill DL, Maio S, Baldacci S, Carrozzi L. Definition, epidemiology and natural history of COPD. Eur Respir J 2007;30:993-1013. https://doi.org/10.1183/09031936.00082507
  2. Zhu B, Wang Y, Ming J, Chen W, Zhang L. Disease burden of COPD in China: a systematic review. Int J Chron Obstruct Pulmon Dis 2018;13:1353-64. https://doi.org/10.2147/COPD.S161555
  3. Kim C, Kim Y, Yang DW, Rhee CK, Kim SK, Hwang YI, et al. Direct and indirect costs of chronic obstructive pulmonary disease in Korea. Tuberc Respir Dis (Seoul) 2019;82:27-34. https://doi.org/10.4046/trd.2018.0035
  4. Barnes PJ. Inflammatory mechanisms in patients with chronic obstructive pulmonary disease. J Allergy Clin Immunol 2016;138:16-27. https://doi.org/10.1016/j.jaci.2016.05.011
  5. MacNee W. Pathogenesis of chronic obstructive pulmonary disease. Proc Am Thorac Soc 2005;2:258-66. https://doi.org/10.1513/pats.200504-045SR
  6. Agusti A, Edwards LD, Rennard SI, MacNee W, Tal-Singer R, Miller BE, et al. Persistent systemic inflammation is associated with poor clinical outcomes in COPD: a novel phenotype. PLoS One 2012;7:e37483. https://doi.org/10.1371/journal.pone.0037483
  7. Kim V, Aaron SD. What is a COPD exacerbation? Current definitions, pitfalls, challenges and opportunities for improvement. Eur Respir J 2018;52:1801261. https://doi.org/10.1183/13993003.01261-2018
  8. Buckley CD, Gilroy DW, Serhan CN. Proresolving lipid mediators and mechanisms in the resolution of acute inflammation. Immunity 2014;40:315-27. https://doi.org/10.1016/j.immuni.2014.02.009
  9. Broekhuizen R, Wouters EF, Creutzberg EC, Weling-Scheepers CA, Schols AM. Polyunsaturated fatty acids improve exercise capacity in chronic obstructive pulmonary disease. Thorax 2005;60:376-82. https://doi.org/10.1136/thx.2004.030858
  10. Lemoine S CM, Brigham EP, Woo H, Hanson CK, McCormack MC, Koch A, et al. Omega-3 fatty acid intake and prevalent respiratory symptoms among U.S. adults with COPD. BMC Pulm Med 2019;19:97. https://doi.org/10.1186/s12890-019-0852-4
  11. Kweon S, Kim Y, Jang MJ, Kim Y, Kim K, Choi S, et al. Data resource profile: the Korea National Health and Nutrition Examination Survey (KNHANES). Int J Epidemiol 2014;43:69-77. https://doi.org/10.1093/ije/dyt228
  12. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J 2005;26:319-38. https://doi.org/10.1183/09031936.05.00034805
  13. Centers for Disease Control and Prevention (CDC). Vital signs: nonsmokers' exposure to secondhand smoke. United States, 1999-2008. MMWR Morb Mortal Wkly Rep 2010;59:1141-6.
  14. Nolan CM, Longworth L, Lord J, Canavan JL, Jones SE, Kon SS, et al. The EQ-5D-5L health status questionnaire in COPD: validity, responsiveness and minimum important difference. Thorax 2016;71:493-500. https://doi.org/10.1136/thoraxjnl-2015-207782
  15. Nam H, Kim K, Kwon S, Koh K, Poul K. EQ-5D Korean valuation study using time trade off method. Seoul (KR): Korea Centers for Disease Control and Prevention; 2007.
  16. Karvetti RL, Knuts LR. Validity of the 24-hour dietary recall. J Am Diet Assoc 1985;85:1437-42.
  17. Seo MH, Lee WY, Kim SS, Kang JH, Kang JH, Kim KK, et al. 2018 Korean Society for the Study of Obesity guideline for the management of obesity in Korea. J Obes Metab Syndr 2019;28:40-5. https://doi.org/10.7570/jomes.2019.28.1.40
  18. Singh D, Vestbo J. Triple therapy in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2017;196:1082-3. https://doi.org/10.1164/rccm.201704-0811LE
  19. Hawthorne G, Richardson J, Osborne R. The Assessment of Quality of Life (AQoL) instrument: a psychometric measure of health-related quality of life. Qual Life Res 1999;8:209-24. https://doi.org/10.1023/A:1008815005736
  20. Esquinas C, Ramon MA, Nunez A, Molina J, Quintano JA, Roman-Rodriguez M, et al. Correlation between disease severity factors and EQ-5D utilities in chronic obstructive pulmonary disease. Qual Life Res 2020;29:607-17. https://doi.org/10.1007/s11136-019-02340-4
  21. Pickard AS, Wilke C, Jung E, Patel S, Stavem K, Lee TA. Use of a preference-based measure of health (EQ-5D) in COPD and asthma. Respir Med 2008;102:519-36. https://doi.org/10.1016/j.rmed.2007.11.016
  22. Cote CG, Pinto-Plata V, Kasprzyk K, Dordelly LJ, Celli BR. The 6-min walk distance, peak oxygen uptake, and mortality in COPD. Chest 2007;132:1778-85. https://doi.org/10.1378/chest.07-2050
  23. Singh D, Agusti A, Anzueto A, Barnes PJ, Bourbeau J, Celli BR, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease: the GOLD science committee report 2019. Eur Respir J 2019;53:1900164. https://doi.org/10.1183/13993003.00164-2019
  24. Charoenwoodhipong P, Harlow SD, Marder W, Hassett AL, McCune WJ, Gordon C, et al. Dietary omega polyunsaturated fatty acid intake and patient-reported outcomes in systemic lupus erythematosus: the Michigan Lupus Epidemiology and Surveillance Program. Arthritis Care Res (Hoboken). 2020;72:874-81. https://doi.org/10.1002/acr.23925
  25. Behboudi-Gandevani S, Hariri FZ, Moghaddam-Banaem L. The effect of omega 3 fatty acid supplementation on premenstrual syndrome and health-related quality of life: a randomized clinical trial. J Psychosom Obstet Gynaecol 2018;39:266-72. https://doi.org/10.1080/0167482X.2017.1348496
  26. Moeinzadeh F, Shahidi S, Mortazavi M, Dolatkhah S, Kajbaf M, Haghjooy Javanmard S, et al. Effects of omega-3 fatty acid supplementation on serum biomarkers, inflammatory agents, and quality of life of patients on hemodialysis. Iran J Kidney Dis 2016;10:381-7.
  27. Croasdell A, Thatcher TH, Kottmann RM, Colas RA, Dalli J, Serhan CN, et al. Resolvins attenuate inflammation and promote resolution in cigarette smoke-exposed human macrophages. Am J Physiol Lung Cell Mol Physiol 2015;309:L888- 901. https://doi.org/10.1152/ajplung.00125.2015
  28. Baylin A, Campos H. Arachidonic acid in adipose tissue is associated with nonfatal acute myocardial infarction in the central valley of Costa Rica. J Nutr 2004;134:3095-9. https://doi.org/10.1093/jn/134.11.3095
  29. Kaikkonen JE, Kresanov P, Ahotupa M, Jula A, Mikkila V, Viikari JS, et al. High serum n6 fatty acid proportion is associated with lowered LDL oxidation and inflammation: the Cardiovascular Risk in Young Finns Study. Free Radic Res 2014;48:420-6. https://doi.org/10.3109/10715762.2014.883071
  30. Noguchi H, Nishi D, Matsumura K, Hamazaki K, Hamazaki T, Matsuoka YJ. Limited effect of omega-3 fatty acids on the quality of life in survivors of traumatic injury: a randomized, placebo-controlled trial. Prostaglandins Leukot Essent Fatty Acids 2017;127:1-5. https://doi.org/10.1016/j.plefa.2017.09.018