Background: The protein-calorie malnutrition, resulting in muscle mass loss, frequently occurs in severe COPD patients\r\nwith chronic respiratory failure (CRF), causing dyspnea, reduced exercise tolerance and impaired quality of life.\r\nThe cause of this occurrence is an intake-output energy imbalance. A documented deficit of phosphocreatine and\r\nreduced mithocondrial energy production can contribute to this imbalance.\r\nAim of this study is to verify whether a dietary supplementation with creatine and coenzyme Q10, important\r\nmitochondrial function factors, is able to influence this mechanism leading to a dyspnea reduction and improving\r\nexercise tolerance and quality of life.\r\nMethods: 55 COPD patients with chronic respiratory failure (in long term O2 therapy), in stable phase of the disease\r\nand without severe comorbidities were assigned (double-blind, randomized) to: group A (30 patients) with daily dietary\r\nsupplementation with Creatine 340 mg 320 mg Coenzyme Q-Ter (Eufortyn�®, Scharper Therapeutics Srl) for 2 months\r\nwhereas Group B (25 patients) received placebo.\r\nAll patients continued the same diet, rehabilitation and therapy during the study. At recruitment (T0) and after\r\n2 months (T1), patients were submitted to medical history, anthropometry (BMI), bioelectrical impedance, arterial blood\r\ngas analysis, evaluation of dyspnea (VAS, Borg, BDI, MRC) and functional independence (ADL), 6-minute walk test\r\n(6MWT) and quality of life questionnaire (SGRQ). At 6 months and 1 year, a telephone follow up was conducted on\r\nexacerbations number.\r\nResults: No significant difference was detected at baseline (T0) in the 2 groups. After 2 months of therapy (T1) the\r\nFFMI increased in the daily dietary supplementation group ( 3.7 %) and decreased in the placebo group (- 0.6 %),\r\nresulting in a statistically significant (p < 0.001) treatment difference. Statistically significant treatment differences,\r\nfavouring daily dietary supplementation group, were also seen for the 6MWT comparison. Group A patients also\r\nshowed significant: 1) improvement in the degree of dyspnea (VAS: p < 0.05; Borg: p < 0.05; MRC: p < 0.001; BDI1:\r\np < 0.05; BDI3: p < 0.03), and independence level in activities of daily living (p < 0.03); 2) improvement in quality of life\r\nin activity section (- 6.63 pt) and in total score (- 5.43 pt); 3) exacerbation number decrease (p < 0.02). No significant\r\ndifferences were found (end of study vs baseline) in group B.
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