ABSTRACT

Background: The inflammatory response to COPD does not only occur in the lungs but also occurs systemically. Systemic inflammation causes muscle protein catabolism through various cytokine pathways, especially TNF (tumor necrosis factor)-α. The breakdown of muscle protein that occurs in COPD patients causes loss of muscle mass, decreased muscle strength, and decreased physical performance called sarcopenia. In COPD patients over 50 years, there was a reduction in muscle mass of 1-2% per year and decrease in muscle strength of 1.5-3% per year. Omega-3 polyunsaturated fatty acids (PUFAs) is a supplement that can modulate the inflammatory processes that occur in COPD and increase muscle mass. At present the omega-3 PUFAs supplement has not been widely used as an additional nutrient in COPD patients with sarcopenia.

Objective: To determine the effect of omega-3 supplementation on serum TNF-α levels, muscle mass, muscle strength, and physical performance in COPD patients with sarcopenia.

Methods: This research is a double-blind randomized clinical controlled trial. The samples was 40 people consisting of  20 the treatment group and 20 the control group. The subjects were followed for 12 weeks, then the treatment effect consisting of TNF-α, muscle mass, muscle strength, and physical performance were measured, analyzed, and compared between pre and post treatment in the treatment group and the control group.

Results: In the treatment group the mean difference of serum TNF-α levels was -45,22 pg/ml while in the control group was 31,92 pg/ml (p <0,001). In the treatment group, the mean difference in muscle mass was 8,1 kg while in the control group was -1,06 kg (p <0,001). In the treatment group, the mean difference of muscle strength was 15,07 while in the control group was -0,57 kg (p <0,001). In the treatment group the median difference of 6MWT was 27 meters while in the control group was 1 meter (p <0.001).

Conclusion: Providing omega-3 supplements can reduce serum TNF-α levels, increase muscle mass, muscle strength, and physical performance in COPD patients with sarcopenia after using for 12 weeks.

Keywords : COPD, sarcopenia, omega 3 supplementation, serum TNF-α, muscle mass, muscle strength, and six minute walking test