Small Intestinal Absorption in Patients With Chronic Obstructive Pulmonary Disease and Cor Pulmonale

Study Overview
=================
Brief Summary
-----------------
Aim: To investigate whether patients with pulmonary hypertension have reduced absorption capacity compared to COPD patients without cor pulmonale potentially due to venous obstruction in the portal vein system. The presence of cor pulmonale was determined by echocardiography. The concentration of D-xylose and zinc were measured in peripheral blood one, two and three hours after ingestion and used as markers of absorption. Furthermore, urine was collected for five hours to determine the amount of excreted D-xylose.

Detailed Description
-----------------
Background: Cor pulmonale is a common complication to Chronic Obstructive Pulmonary Disease (COPD), and may result in increased pressure in the inferior caval vein and stasis of the liver. The chronic pulmonary hypertension may lead to stasis in the veins from the small intestine and thereby compromise absorption of nutrients. Aim: To investigate whether patients with pulmonary hypertension have reduced absorption capacity compared to COPD patients without cor pulmonale. Methods: Absorption of D-xylose (25 g) and zinc (132 mg), administered as a single dose, was tested in 14 COPD patients, seven with and seven without cor pulmonale. The presence of cor pulmonale was determined by echocardiography. The concentration of D-xylose and zinc were measured in peripheral blood one, two and three hours after ingestion and used as markers of absorption. Furthermore, urine was collected for five hours to determine the amount of excreted D-xylose.

Official Title
-----------------
Small Intestinal Absorption in Patients With Chronic Obstructive Pulmonary Disease Complicated by Cor Pulmonale: A Pilot Study

Conditions
-----------------
Chronic Obstructive Pulmonary Disease, Cor Pulmonale

Intervention / Treatment
-----------------
* Diagnostic Test: Absorption test with D-xylose and zink


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: A diagnosis of COPD Clinically stable = Unchanged medication for COPD for at least 6 months Exclusion Criteria: Unable to understand Danish Other clinically important heart-disease than chronic right heart changes presumably due to lung disease Clinically significant gastro-intestinal or kidney disease Diabetes Treatment with corticosteroids for at least 6 months.

Ages Eligible for Study
-----------------
Minimum Age: 60 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Diagnostic
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: All patients had Chronic Obstructive Lung Disease. Those with additional Cor pulmonale was compared to those without
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: COPD<br>Patients with COPD without Cor Pulmonale | Diagnostic Test: Absorption test with D-xylose and zink<br>* Absorption of D-xylose (25 g) and zinc (132 mg), administered as a single dose. The concentration of D-xylose and zinc was measured in peripheral blood one, two and three hours after ingestion and used as markers of absorption. Furthermore, urine was collected for five hours to determine the amount of excreted D-xylose.<br>|
| Experimental: COPD + Cor Pulmonale<br>Patients with Cor Pulmonale in addition | Diagnostic Test: Absorption test with D-xylose and zink<br>* Absorption of D-xylose (25 g) and zinc (132 mg), administered as a single dose. The concentration of D-xylose and zinc was measured in peripheral blood one, two and three hours after ingestion and used as markers of absorption. Furthermore, urine was collected for five hours to determine the amount of excreted D-xylose.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Absorption fraction of D-xylose | plasma concentration, mmol/l | 3 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Absorption of zinc | plasma concentration, micromol/l | 3 hours | 
| Absorption fraction of D-xylose | urine excretion, mmol | 5 hours | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Cor pulmonale, COPD, Malabsorption, D-xylose, Zinc