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Attaway AH, Lopez R, Welch N, Bellar A, Hatipoğlu U, Zein J, Engelen MP, Dasarathy S. Muscle loss phenotype in COPD is associated with adverse outcomes in the UK Biobank. BMC Pulm Med 2024; 24:186. [PMID: 38632546 PMCID: PMC11025247 DOI: 10.1186/s12890-024-02999-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 04/08/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disorder with systemic consequences that can cause a muscle loss phenotype (MLP), which is characterized by the loss of muscle mass, muscle strength, or loss of both muscle and fat mass. There are limited data comparing the individual traits of MLP with clinical outcomes in a large unbiased cohort of COPD patients. Our aim was to determine the proportion of patients who met criteria for MLP in an unbiased sample of COPD patients at the population-level. We also determined if specific MLP features were associated with all-cause and COPD-related mortality. METHODS A retrospective population-based cohort analysis of the UK Biobank was performed. COPD was defined by a FEV1/FVC ratio < 0.7, physician established diagnosis of COPD, or those with a COPD-related hospitalization before baseline assessment. MLP included one or more of the following: 1) Low fat-free mass index (FFMI) on bioelectric impedance analysis (BIA) or 2) Appendicular skeletal muscle index (ASMI) on BIA, 3) Low muscle strength defined by handgrip strength (HGS), or 4) Low muscle and fat mass based on body mass index (BMI). Cox regression was used to determine the association between MLP and all-cause or COPD-related mortality. All models were adjusted for sex, age at assessment, ethnicity, BMI, alcohol use, smoking status, prior cancer diagnosis and FEV1/FVC ratio. RESULTS There were 55,782 subjects (56% male) with COPD followed for a median of 70.1 months with a mean(± SD) age at assessment of 59 ± 7.5 years, and FEV1% of 79.2 ± 18.5. Most subjects had mild (50.4%) or moderate (42.8%) COPD. Many patients had evidence of a MLP, which was present in 53.4% of COPD patients (34% by ASMI, 26% by HGS). Of the 5,608 deaths in patients diagnosed with COPD, 907 were COPD-related. After multivariate adjustment, COPD subjects with MLP had a 30% higher hazard-ratio for all-cause death and 70% higher hazard-ratio for COPD-related death. CONCLUSIONS Evidence of MLP is common in a large population-based cohort of COPD and is associated with higher risk for all-cause and COPD-related mortality.
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Affiliation(s)
- Amy H Attaway
- Departments of Pulmonary Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Rocio Lopez
- Center for Populations Health Research, Cleveland Clinic, Cleveland, OH, USA
| | - Nicole Welch
- Inflammation and Immunity, Cleveland Clinic, Cleveland, OH, USA
- Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, USA
| | - Annette Bellar
- Inflammation and Immunity, Cleveland Clinic, Cleveland, OH, USA
| | - Umur Hatipoğlu
- Departments of Pulmonary Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Joe Zein
- Department of Medicine, Mayo Clinic, Scottsdale, AZ, USA
| | | | - Srinivasan Dasarathy
- Inflammation and Immunity, Cleveland Clinic, Cleveland, OH, USA.
- Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, USA.
- Department of Inflammation and Immunity, Lerner Research Institute, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
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Wienker J, Darwiche K, Rüsche N, Büscher E, Karpf-Wissel R, Winantea J, Özkan F, Westhölter D, Taube C, Kersting D, Hautzel H, Salhöfer L, Hosch R, Nensa F, Forsting M, Schaarschmidt BM, Zensen S, Theysohn J, Umutlu L, Haubold J, Opitz M. Body composition impacts outcome of bronchoscopic lung volume reduction in patients with severe emphysema: a fully automated CT-based analysis. Sci Rep 2024; 14:8718. [PMID: 38622275 PMCID: PMC11018765 DOI: 10.1038/s41598-024-58628-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 04/01/2024] [Indexed: 04/17/2024] Open
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is characterized by progressive and irreversible airflow limitation, with individual body composition influencing disease severity. Severe emphysema worsens symptoms through hyperinflation, which can be relieved by bronchoscopic lung volume reduction (BLVR). To investigate how body composition, assessed through CT scans, impacts outcomes in emphysema patients undergoing BLVR. Fully automated CT-based body composition analysis (BCA) was performed in patients with end-stage emphysema receiving BLVR with valves. Post-interventional muscle and adipose tissues were quantified, body size-adjusted, and compared to baseline parameters. Between January 2015 and December 2022, 300 patients with severe emphysema underwent endobronchial valve treatment. Significant improvements were seen in outcome parameters, which were defined as changes in pulmonary function, physical performance, and quality of life (QoL) post-treatment. Muscle volume remained stable (1.632 vs. 1.635 for muscle bone adjusted ratio (BAR) at baseline and after 6 months respectively), while bone adjusted adipose tissue volumes, especially total and pericardial adipose tissue, showed significant increase (2.86 vs. 3.00 and 0.16 vs. 0.17, respectively). Moderate to strong correlations between bone adjusted muscle volume and weaker correlations between adipose tissue volumes and outcome parameters (pulmonary function, QoL and physical performance) were observed. Particularly after 6-month, bone adjusted muscle volume changes positively corresponded to improved outcomes (ΔForced expiratory volume in 1 s [FEV1], r = 0.440; ΔInspiratory vital capacity [IVC], r = 0.397; Δ6Minute walking distance [6MWD], r = 0.509 and ΔCOPD assessment test [CAT], r = -0.324; all p < 0.001). Group stratification by bone adjusted muscle volume changes revealed that groups with substantial muscle gain experienced a greater clinical benefit in pulmonary function improvements, QoL and physical performance (ΔFEV1%, 5.5 vs. 39.5; ΔIVC%, 4.3 vs. 28.4; Δ6MWDm, 14 vs. 110; ΔCATpts, -2 vs. -3.5 for groups with ΔMuscle, BAR% < -10 vs. > 10, respectively). BCA results among patients divided by the minimal clinically important difference for forced expiratory volume of the first second (FEV1) showed significant differences in bone-adjusted muscle and intramuscular adipose tissue (IMAT) volumes and their respective changes after 6 months (ΔMuscle, BAR% -5 vs. 3.4 and ΔIMAT, BAR% -0.62 vs. 0.60 for groups with ΔFEV1 ≤ 100 mL vs > 100 mL). Altered body composition, especially increased muscle volume, is associated with functional improvements in BLVR-treated patients.
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Affiliation(s)
- Johannes Wienker
- Division of Interventional Pneumology, Department of Pulmonary Medicine, University Medicine Essen-Ruhrlandklinik, Tüschener Weg 40, 45239, Essen, Germany.
| | - Kaid Darwiche
- Division of Interventional Pneumology, Department of Pulmonary Medicine, University Medicine Essen-Ruhrlandklinik, Tüschener Weg 40, 45239, Essen, Germany
| | - Nele Rüsche
- Division of Interventional Pneumology, Department of Pulmonary Medicine, University Medicine Essen-Ruhrlandklinik, Tüschener Weg 40, 45239, Essen, Germany
| | - Erik Büscher
- Division of Interventional Pneumology, Department of Pulmonary Medicine, University Medicine Essen-Ruhrlandklinik, Tüschener Weg 40, 45239, Essen, Germany
| | - Rüdiger Karpf-Wissel
- Division of Interventional Pneumology, Department of Pulmonary Medicine, University Medicine Essen-Ruhrlandklinik, Tüschener Weg 40, 45239, Essen, Germany
| | - Jane Winantea
- Division of Interventional Pneumology, Department of Pulmonary Medicine, University Medicine Essen-Ruhrlandklinik, Tüschener Weg 40, 45239, Essen, Germany
| | - Filiz Özkan
- Division of Interventional Pneumology, Department of Pulmonary Medicine, University Medicine Essen-Ruhrlandklinik, Tüschener Weg 40, 45239, Essen, Germany
| | - Dirk Westhölter
- Department of Pulmonary Medicine, University Medicine Essen-Ruhrlandklinik, Essen, Germany
| | - Christian Taube
- Department of Pulmonary Medicine, University Medicine Essen-Ruhrlandklinik, Essen, Germany
| | - David Kersting
- Department of Nuclear Medicine, University Hospital Essen, Essen, Germany
| | - Hubertus Hautzel
- Department of Nuclear Medicine, University Hospital Essen, Essen, Germany
| | - Luca Salhöfer
- Institute for Artificial Intelligence in Medicine, University Hospital Essen, Essen, Germany
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - René Hosch
- Institute for Artificial Intelligence in Medicine, University Hospital Essen, Essen, Germany
| | - Felix Nensa
- Institute for Artificial Intelligence in Medicine, University Hospital Essen, Essen, Germany
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Michael Forsting
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Benedikt M Schaarschmidt
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Sebastian Zensen
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Jens Theysohn
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Lale Umutlu
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Johannes Haubold
- Institute for Artificial Intelligence in Medicine, University Hospital Essen, Essen, Germany
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Marcel Opitz
- Institute for Artificial Intelligence in Medicine, University Hospital Essen, Essen, Germany
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
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Santos-de-Araújo AD, da Luz Goulart C, Marinho RS, Dourado IM, Mendes RG, Roscani MG, Bassi-Dibai D, Phillips SA, Arena R, Borghi-Silva A. The six-minute step test can predict COPD exacerbations: a 36-month follow-up study. Sci Rep 2024; 14:3649. [PMID: 38351306 PMCID: PMC10864352 DOI: 10.1038/s41598-024-54338-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 02/12/2024] [Indexed: 02/16/2024] Open
Abstract
The six-minute step test (6MST) has been shown to be effective in assessing exercise capacity in individuals with COPD regardless of severity and, despite its easy execution, accessibility and validity, information on the prognostic power of this test remains uncertain. The aim of this study is to investigate whether the 6MST can predict the occurrence of exacerbations in patients with COPD. This is a prospective cohort study with a 36-month follow-up in patients with COPD. All patients completed a clinical assessment, followed by pulmonary function testing and a 6MST. The 6MST was performed on a 20 cm high step; heart rate, blood pressure, oxygen saturation, BORG dyspnea and fatigue were collected. Sixty-four patients were included in the study, the majority being elderly men. Performance on the 6MST demonstrated lower performance compared to normative values proposed in the literature, indicating a reduced functional capacity. Kaplan Meier analysis revealed that ≤ 59 steps climbed during the 6MST was a strong predictor of COPD exacerbation over a 36-month follow-up. We have identified a minimal threshold number of steps (≤ 59) obtained through the 6MST may be able predict the risk of exacerbations in patients with COPD.
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Affiliation(s)
| | - Cássia da Luz Goulart
- Cardiopulmonary Physiotherapy Laboratory, Universidade Federal de São Carlos, São Carlos, SP, 13565-905, Brazil
| | - Renan Shida Marinho
- Cardiopulmonary Physiotherapy Laboratory, Universidade Federal de São Carlos, São Carlos, SP, 13565-905, Brazil
| | - Izadora Moraes Dourado
- Cardiopulmonary Physiotherapy Laboratory, Universidade Federal de São Carlos, São Carlos, SP, 13565-905, Brazil
| | - Renata Gonçalves Mendes
- Cardiopulmonary Physiotherapy Laboratory, Universidade Federal de São Carlos, São Carlos, SP, 13565-905, Brazil
| | - Meliza Goi Roscani
- Department of Medicine, Universidade Federal de São Carlos (UFSCar), Sao Carlos, SP, Brazil
| | - Daniela Bassi-Dibai
- Postgraduate Program in Management in Health Programs and Services, Universidade CEUMA, São Luís, MA, Brazil
| | - Shane A Phillips
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, USA
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, USA
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Universidade Federal de São Carlos, São Carlos, SP, 13565-905, Brazil.
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Feltrin TD, Gracioli MDSP, Cielo CA, Souza JA, Moraes DADO, Pasqualoto AS. Maximum Phonation Times as Biomarkers of Lung Function. J Voice 2024:S0892-1997(23)00406-X. [PMID: 38331702 DOI: 10.1016/j.jvoice.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 02/10/2024]
Abstract
PURPOSE To verify whether measurements of maximal phonation times are biomarkers of forced vital capacity in patients with chronic obstructive pulmonary disease, and to characterize the vocal aspects of these patients, taking into account variables, such as age, body mass index, use of bronchodilators, presence of symptoms, and quality of life related to voice. METHODS Complete records of 25 subjects with chronic obstructive pulmonary disease, both sexes, aged 31 to 85 years, evaluated by forced vital capacity, maximum phonation times of /a/, and numerical count and number reached at this count, Vocal Symptom Scale, Voice Quality of Life. Data were presented descriptively and statistically analyzed using Student's t test for independent samples and Mann-Whitney U test. A significance level of 5% was accepted. The receiver operating characteristic curve was plotted and the standardized value of forced vital capacity <80% was considered as an indicator of pulmonary dysfunction. RESULTS Patients exhibited reduced maximum phonation times for /a/, numeric counting, and reached digits in counting; discrepancies in Vocal Signs and Symptoms and Voice Quality of Life Scale scores. Numeric counting times of up to 12.5 seconds indicated that forced vital capacity may be impaired. CONCLUSION The patients with chronic obstructive pulmonary disease examined in this study exhibited vocal deviations as evidenced by reduced maximum phonation times of /a/, numeric counting, and the digit reached during counting, as well as deviations in vocal self-assessment. Maximum phonation time in numerical counting was considered a biomarker of pulmonary function impairment.
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Choi YJ, Park HJ, Cho JH, Byun MK. Low Skeletal Muscle Mass and Clinical Outcomes in Chronic Obstructive Pulmonary Disease. Tuberc Respir Dis (Seoul) 2023; 86:272-283. [PMID: 37582676 PMCID: PMC10555524 DOI: 10.4046/trd.2023.0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/21/2023] [Accepted: 08/05/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND In patients with chronic obstructive pulmonary disease (COPD), decreased muscle mass is a frequently encountered comorbidity in clinical practice. However, the evaluation of muscle mass in patients with COPD in real-world practice is rare. METHODS We retrospectively reviewed the electronic medical records of all patients with COPD who underwent bioelectrical impedance analysis at least once between January 2011 and December 2021 in three hospitals. Then, we analyzed the performance rate of muscle mass measurement in the patients and the correlation between muscle mass, clinical parameters, and COPD prognosis. RESULTS Among the 24,502 patients with COPD, only 270 (1.1%) underwent muscle mass measurements. The total skeletal muscle mass index was significantly correlated with albumin, alanine transaminase, and creatinine to cystatin C ratio in patients with COPD (r=0.1614, p=0.011; r=0.2112, p=0.001; and r=0.3671, p=0.001, respectively). Acute exacerbation of COPD (AE COPD) was significantly correlated with muscle mass, especially the truncal skeletal muscle mass index (TSMI) in males (r=-0.196, p=0.007). In the multivariate analysis, TSMI and cystatin C were significant risk factors for AE COPD (hazard ratio, 0.200 [95% confidence interval, CI, 0.048 to 0.838] and 4.990 [95% CI, 1.070 to 23.278], respectively). CONCLUSION Low muscle mass negatively affects the clinical outcomes in patients with COPD. Despite its clinical significance, muscle mass measurement is performed in a small proportion of patients with COPD. Therefore, protocols and guidelines for the screening of sarcopenia in patients with COPD should be established.
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Affiliation(s)
- Yong Jun Choi
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye Jung Park
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae Hwa Cho
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Min Kwang Byun
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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M Y, Dave AK, Patel SS, Parbat R, Shah V, Gandhi R. Association Between Sarcopenia and Chronic Renal Failure (Overt and Concealed) in Chronic Obstructive Pulmonary Disease (COPD) Patients: A Cross-Sectional Study. Cureus 2023; 15:e46870. [PMID: 37954830 PMCID: PMC10638108 DOI: 10.7759/cureus.46870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 11/14/2023] Open
Abstract
Background Sarcopenia, a syndrome characterized by a progressive decline in skeletal muscle mass, strength, and function, is frequently associated with chronic diseases such as chronic obstructive pulmonary disease (COPD). Chronic kidney disease (CKD) is a prevalent condition among patients with sarcopenia. Reports suggest that between 15% and 55% of stable COPD patients have sarcopenia. Therefore, the present study aims to determine the association between sarcopenia and chronic renal failure (overt and concealed) in COPD patients. Methodology This institutional-based cross-sectional study was conducted on patients diagnosed with COPD. Hospitalized adult COPD patients who gave consent were included. Sociodemographic information such as age, gender, residence, and prolonged length of stay in the hospital (categorized by a median of 10 days, considering its data distribution in our sample) was obtained using electronic medical records. Skeletal muscle %, visceral fat %, and body fat % were calculated using a bio-electrical impedance analysis device (Omron Body Composition Monitor, Model HBF-702T). Additionally, the strength of the hand grip was measured using a hand dynamometer. Sarcopenia was assessed following the criteria set by the Asian Working Group on Sarcopenia (AWGS). Chronic renal failure (CRF) was assessed by calculating the glomerular filtration rate (GFR) using the Modification of Diet in Renal Disease (MDRD) Study Group equation. Quantitative data were compared using an independent sample t-test. The association was determined using chi-square and multivariate logistic regression analyses. A p-value of <0.05 was considered significant. Results The study found that the proportion of sarcopenia in COPD patients was 52%, with overt and concealed CRF prevalence rates of 31.5% and 27%, respectively. Sarcopenic individuals had significantly lower FEV1 and FEV1/FVC compared to non-sarcopenic patients. The incidence of sarcopenia significantly increased with rising BODE index (body mass index (BMI, B), airflow obstruction (O) as measured by the post-bronchodilator FEV1 (percentage of predicted value), dyspnea (D) assessed by the modified Medical Research Council (MMRC) score, and exercise tolerance (E) measured by 6-minute walking distance) and mMRC (modified Medical Research Council dyspnea scale) dyspnea scale scores. Both concealed CRF and overt CRF patients had four times higher odds of having sarcopenia (AOR=4). Conclusion The study reveals a high prevalence of sarcopenia and provides evidence for the association between sarcopenia and chronic renal failure in COPD patients. These findings underscore the importance of early detection and management of sarcopenia and CRF in COPD patients to optimize their clinical outcomes.
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Affiliation(s)
- Yogesh M
- Community Medicine, Shri M. P. Shah Government Medical College, Jamnagar, IND
| | - Anjali K Dave
- Community Medicine, Shri M. P. Shah Government Medical College, Jamnagar, IND
| | - Shubham S Patel
- Community Medicine, Shri M. P. Shah Government Medical College, Jamnagar, IND
| | - Ram Parbat
- Community and Family Medicine, Shri M. P. Shah Government Medical College, Jamnagar, IND
| | - Viral Shah
- Community and Family Medicine, Shri M. P. Shah Government Medical College, Jamnagar, IND
| | - Rohankumar Gandhi
- Community and Family Medicine, Shri M. P. Shah Government Medical College, Jamnagar, IND
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Choi YJ, Kim T, Park HJ, Cho JH, Byun MK. Long-Term Clinical Outcomes of Patients with Chronic Obstructive Pulmonary Disease with Sarcopenia. Life (Basel) 2023; 13:1628. [PMID: 37629485 PMCID: PMC10455166 DOI: 10.3390/life13081628] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Sarcopenia with muscle wasting and weakness is a common occurrence among patients with chronic obstructive pulmonary disease (COPD). We aimed to evaluate the clinical outcomes of sarcopenia in patients with COPD. METHODS We reviewed the electronic medical records of 71 patients with COPD between 1 January 2012, and 31 December 2018. We longitudinally analyzed clinical outcomes in patients with COPD with and without sarcopenia. RESULTS Compared to the non-sarcopenia group COPD, the sarcopenia group showed a higher rate of acute exacerbation events of COPD (AE COPD, 84.6% vs. 31.0%, p = 0.001), all-cause mortality (30.8% vs. 5.2%, p = 0.022), and pneumonia occurrence per year (median [first quartile-third quartile]; 0.2 [0.0-1.6] vs. 0.0 [0.0-0.2], p = 0.025). Sarcopenia was an independent risk factor for AE COPD in Cox regression analysis (hazard ratio, 5.982; 95% confidence interval, 1.576-22.704). Hand grip strength was associated with the COPD Assessment Test (CAT) score and annual Charlson's comorbidity index score change. Total skeletal muscle mass index (SMMI) was associated with the modified medical research council dyspnea scale score, CAT score, body mass index, airflow obstruction, dyspnea, and exercise (BODE) index, and alanine transaminase. Trunk SMMI was significantly associated with AE COPD, while appendicular SMMI was associated with BODE index and annual intensive care unit admissions for AE COPD. CONCLUSIONS Sarcopenia is associated with clinical prognosis, pneumonia occurrence, and the acute exacerbation of COPD requiring intensive care in patients with COPD. Therefore, it is important to carefully monitor sarcopenia development as well as recommend appropriate exercise and nutritional supplementation in patients with COPD.
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Affiliation(s)
| | | | | | | | - Min Kwang Byun
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea; (Y.J.C.); (T.K.); (H.J.P.); (J.H.C.)
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Wang K, Jia S, Zhao W, Ge M, Dong B. The creatinine-to-cystatin C ratio (a surrogate marker of muscle mass) as a predictor of lung function decline in older adults: A nationwide longitudinal study in China. Respir Med 2023; 211:107197. [PMID: 36889519 DOI: 10.1016/j.rmed.2023.107197] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 02/13/2023] [Accepted: 03/06/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND Lung function decline is associated with sarcopenia, known as loss of skeletal muscle mass. The serum creatinine to cystatin C ratio (CCR) has been proposed as a biomarker of muscle mass. The associations between CCR and lung function decline are unknown. METHODS The study used two waves of data from China Health and Retirement Longitudinal Study (CHARLS) in 2011 and 2015. Serum creatinine and cystatin C were collected at baseline survey (2011). Lung function was assessed by peak expiratory flow (PEF) at 2011 and 2015. Linear regression models adjusted for potential confounders were conducted to analyze the cross-sectional association between CCR and PEF, and the longitudinal association between CCR and annual decline in PEF. RESULTS Totally, 5812 participants aged over 50 years (50.8% women; mean age 63.3 ± 6.5 years) were enrolled in a cross-sectional analysis in 2011, and further 4164 individuals were followed up in 2015. Serum CCR was positively associated with PEF and the PEF% pred. Per 1 SD higher of CCR was associated with 41.55 L/min increases in PEF (p < 0.001) and 10.77 (%) increase in PEF% pred (p < 0.001). Longitudinal analyses indicated that higher CCR level at baseline was related to slower annual decline in PEF and PEF% pred. And this relationship was significant only in women and in never smokers. CONCLUSIONS Higher CCR was associated with slower longitudinal PEF decline in women and never smokers. CCR may be a valuable marker to monitor and predict lung function decline in middle-aged and older adults.
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Affiliation(s)
- Ke Wang
- Division of Pulmonary Diseases, State Key Laboratory of Biotherapy, and Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Shuli Jia
- Center of Gerontology and Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, China
| | - Wanyu Zhao
- Center of Gerontology and Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, China
| | - Meiling Ge
- Center of Gerontology and Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, China.
| | - Birong Dong
- Center of Gerontology and Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, China.
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Won HK, Kang Y, An J, Lee JH, Song WJ, Kwon HS, Cho YS, Moon HB, Jang IY, Kim TB. Relationship between asthma and sarcopenia in the elderly: a nationwide study from the KNHANES. J Asthma 2023; 60:304-313. [PMID: 35225127 DOI: 10.1080/02770903.2022.2047716] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Few studies have investigated the relationship between asthma and sarcopenia. We aimed to examine the relationship between asthma and sarcopenia in a community-dwelling geriatric population, especially regarding lung function and asthma control. METHODS A cross-sectional dataset from the Korean National Health and Nutrition Examination Survey 2008-2011 was utilized. Data regarding asthma history, age at asthma onset, recent asthma exacerbations, and hospitalization for asthma exacerbations were obtained using structured questionnaires. Appendicular skeletal muscle was calculated as the sum of the skeletal muscle mass, and physical activity was assessed using the International Physical Activity Questionnaire. RESULTS Asthma presented an estimated incidence of 6.17 ± 0.37% in the elderly. Groups were divided and analyzed according to asthma, muscle mass, and physical activity. Sarcopenia was associated with aging, male sex, smoking history, low body mass index (BMI), and reduced lung function with or without asthma. Sarcopenic asthma had a younger onset and reduced physical activity than non-sarcopenic asthma. Obstructive patterns were more frequent in asthmatics exhibiting low or moderate physical activity levels than in those with high activity, but asthma control was not associated with sarcopenia and physical activity. Multivariate logistic regression analyses showed that compared with control, sarcopenic asthma was associated with FEV1 < 60%, and airway obstruction, and with aging, male, and lower BMI, compared with non-sarcopenic asthma. CONCLUSIONS Our findings suggest that decreased muscle mass and physical activity levels contribute to reduced lung function in elderly asthmatics. Furthermore, sarcopenic asthma was associated with aging, low BMI, and reduced lung function in the elderly.
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Affiliation(s)
- Ha-Kyeong Won
- Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea.,Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yewon Kang
- Department of Pulmonology and Allergy, Dongkang Hospital, Ulsan, Korea
| | - Jin An
- Department of Pulmonary, Allergy, and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Ji-Hyang Lee
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo-Jung Song
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyouk-Soo Kwon
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - You Sook Cho
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hee-Bom Moon
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Il-Young Jang
- Division of Geriatric Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae-Bum Kim
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Rodrigues RS, Rabelo NN, Telles JPM, Solla DJF, Coelho ACSDS, Jacobsen Teixeira M, Figueiredo EG. Sarcopenia as a Predictor of the Functional Outcome in Patients with Intracranial Aneurysms. Gerontology 2023; 69:65-72. [PMID: 35584617 DOI: 10.1159/000524572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 04/10/2022] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Radiological indicators in head computed tomography (CT) scan have emerged as tools to evaluate sarcopenia using the sectional area and thickness of the temporal muscle. They can be obtained by standardized measurements in preoperative image assessment of patients with brain aneurysms. We aimed to evaluate the association between functional outcomes after interventions for intracranial aneurysms (IAs) and temporal muscle thickness (TMT) and area (TMA), as surrogates of sarcopenia. METHODS This is a prospective observational cohort study in patients who underwent microsurgery or embolization for ruptured or unruptured IA between January 2018 and December 2019, with a 6-month follow-up. Preoperative CT scans were analyzed to measure TMT and TMA. The functional outcome was assessed by the modified Rankin Scale (mRS). The main outcome was the relationship between sarcopenia and the postoperative functional outcome. RESULTS A total of 361 patients were included, of whom 199 (55.1%) had ruptured and 162 (44.9%) had unruptured lesions. Larger TMA significantly predicted better functional outcomes at discharge. TMT was associated with functional outcomes at both discharge and 6 months, adjusted for rupture and hypertension. Maximizing the sum sensitivity-specificity, an optimal TMT cutoff of 6.25 mm can predict unfavorable outcomes. Maximizing the positive predictive value × negative predictive value of a product, the cutpoint was 3.55 mm. CONCLUSIONS Sarcopenia, represented by TMT and TMA, is associated with poorer functional results at discharge and 6-month follow-up in IA surgery. TMT below 6.25 mm was associated with unfavorable functional outcomes. These easily obtainable measurements may improve the decision-making process for patients with IAs.
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Affiliation(s)
- Renan Salomão Rodrigues
- Division of Neurosurgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Nicollas Nunes Rabelo
- Division of Neurosurgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - João Paulo Mota Telles
- Division of Neurosurgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Davi Jorge Fontoura Solla
- Division of Neurosurgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Manoel Jacobsen Teixeira
- Division of Neurosurgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Eberval Gadelha Figueiredo
- Division of Neurosurgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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11
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He J, Li H, Yao J, Wang Y. Prevalence of sarcopenia in patients with COPD through different musculature measurements: An updated meta-analysis and meta-regression. Front Nutr 2023; 10:1137371. [PMID: 36875833 PMCID: PMC9978530 DOI: 10.3389/fnut.2023.1137371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 01/31/2023] [Indexed: 02/18/2023] Open
Abstract
Aim Chronic obstructive pulmonary disease (COPD) patients vary widely in terms of the prevalence of sarcopenia, which is partially attributed to differences in diagnostic criteria and disease severity. There are several different musculature measurements that are used to quantify sarcopenia. This study included published literature for meta-analysis to assess the sarcopenia prevalence in COPD patients and correlate the disease with the clinical characteristics of such patients. Methods A comprehensive review of the English and Chinese literature on sarcopenia prevalence in COPD patients was conducted using electronic databases such as China National Knowledge Infrastructure (CNKI), Web of Science, Cochrane Library, EMBASE, PubMed, and Wanfang. Two researchers analyzed the studies for Newcastle-Ottawa Scale. The software Stata 11.0 was employed for the analysis of the acquired data. The standard mean differences method was utilized for the estimation and quantification of the effect size. Furthermore, a fixed- or random-effects model was employed for conducting a combined analysis. Results In total, 56 studies were included as per the specific inclusion criteria. The resulting data of the assessed COPD patients in this research indicated a 27% prevalence of sarcopenia. Further analysis of subgroups was executed per disease severity, ethnicity, diagnostic criteria, gender, and age. Per these findings, increased disease severity elevated the prevalence of sarcopenia. The Latin American and Caucasian populations indicated an increased prevalence of sarcopenia. In addition, the prevalence of sarcopenia was related to diagnostic criteria and definition. Male COPD patients had a higher prevalence of sarcopenia than female COPD patients. COPD patients with an average age greater than 65 had a slightly higher prevalence of sarcopenia. COPD patients with comorbid sarcopenia had poorer pulmonary function, activity tolerance, and clinical symptoms than patients with COPD alone. Conclusion Sarcopenia prevalence is high (27%) in COPD patients. In addition, these patients had worse pulmonary function and activity tolerance compared to patients without sarcopenia. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=367422, identifier CRD42022367422.
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Affiliation(s)
- Jie He
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China.,Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Hezhi Li
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China.,Department of Anesthesiology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Jun Yao
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China.,Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Yan Wang
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China.,Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
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12
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Reduced Skeletal Muscle Mass Is Associated with an Increased Risk of Asthma Control and Exacerbation. J Clin Med 2022; 11:jcm11237241. [PMID: 36498815 PMCID: PMC9738130 DOI: 10.3390/jcm11237241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/28/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Skeletal muscle mass (SMM) has been suggested to be associated with multiple health-related outcomes. However, the potential influence of SMM on asthma has not been largely explored. OBJECTIVE To study the association between SMM and clinical features of asthma, including asthma control and exacerbation, and to construct a model based on SMM to predict the risk of asthma exacerbation (AEx). METHODS In this prospective cohort study, we consecutively recruited patients with asthma (n = 334), classified as the SMM Normal group (n = 223), SMM Low group (n = 88), and SMM High group (n = 23). We investigated the association between SMM and clinical asthma characteristics and explored the association between SMM and asthma control and AEx within a 12-month follow-up period. Based on SMM, an exacerbation prediction model was developed, and the overall performance was externally validated in an independent cohort (n = 157). RESULTS Compared with the SMM Normal group, SMM Low group exhibited more airway obstruction and worse asthma control, while SMM High group had a reduced eosinophil percentage in induced sputum. Furthermore, SMM Low group was at a significantly increased risk of moderate-to-severe exacerbation compared with the SMM Normal group (relative risk adjusted 2.02 [95% confidence interval (CI), 1.35-2.68]; p = 0.002). In addition, a model involving SMM was developed which predicted AEx (area under the curve: 0.750, 95% CI: 0.691-0.810). CONCLUSIONS Low SMM was an independent risk factor for future AEx. Furthermore, a model involving SMM for predicting the risk of AEx in patients with asthma indicated that assessment of SMM has potential clinical implications for asthma management.
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13
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Sex Difference in Cutoff and Prevalence of Sarcopenia among 300,090 Urban Korean Population: Association with Metabolic Syndrome. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58101361. [PMID: 36295523 PMCID: PMC9611231 DOI: 10.3390/medicina58101361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/22/2022] [Accepted: 09/25/2022] [Indexed: 12/18/2022]
Abstract
Background and Objectives: The study aimed to establish the threshold values and prevalence of sarcopenia and to investigate the association of sarcopenia with metabolic syndrome in an urban Korean population. Materials and Methods: The study included 300,090 adults who underwent anthropometric analyses by bioelectrical impedance analyzer. Sarcopenia was defined as: (1) class I, skeletal muscle mass index (SMI) within −1 to −2 standard deviations (SDs); (2) or class II, <−2 SD of SMI in a young population. Results: Low SMI threshold levels for class I and class II sarcopenia were 39.8 and 36.7% in men, and 35.5 and 32.3% in women. Among all age groups, the prevalence rates of sarcopenia were highest in the age group 80−89 years. Following adjustment for possible confounders including age, sex, height, metabolic and health behavioral factors, adjusted odds ratios (95% confidence intervals) for the risk of metabolic syndrome were 2.43 (2.33−2.54) for class I and 2.69 (2.49−2.91) for class II sarcopenia, compared with the normal reference. Sarcopenia was more strongly associated with metabolic syndrome in women than men (p for interaction < 0.01). The threshold values and prevalence of sarcopenia were demonstrated in a large Korean urban population. Conclusions: This study identified that sarcopenia was associated with increased risk of metabolic syndrome, showing itself to be significantly higher in women than men.
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14
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Yao R, Yao L, Rao A, Ou J, Wang W, Hou Q, Xu C, Gao BL. Prevalence and risk factors of stroke-related sarcopenia at the subacute stage: A case control study. Front Neurol 2022; 13:899658. [PMID: 36003303 PMCID: PMC9393529 DOI: 10.3389/fneur.2022.899658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 07/15/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose To investigate the prevalence and risk factors of stroke-related sarcopenia (SRS) in hospitalized patients receiving rehabilitation treatment. Methods Approximately, 259 patients with stroke that satisfied the inclusion and exclusion criteria were consecutively recruited between June 2020 and July 2022. The epidemiologic data, history, clinical data, and measured data of the skeletal muscle index were collected. The patients were divided into the sarcopenia and non-sarcopenia group for comparison and analysis with the univariate and multivariate analysis. Results SRS was presented in 121 (46.7%) patients with a mean age of 59.6 ± 9.7 years, including 42 women and 79 men. Multivariate logistic regression analysis revealed the following parameters to be significant (p < 0.05) risk factors for SRS: college degree or above (OR, 2.1, 95% CI, 1.1–4.1), ICU stay (OR, 1.7, 95% CI, 1.06–2.8), pneumonia (OR, 1.9, 9% CI, 1.1–3.6), walking ability (OR, 2.6, 95% CI, 1.5–4.6), cognitive impairment (OR, 1.8, 95%, 1.1–2.9), aphasia (OR, 2.1, 95% CI, 1.2–3.5), nasogastric feeding (OR, 3.7, 95%, 1.9–7.3), age (OR, 1.04, 95% CI, 1–1.1), and creatine kinase (OR, 1.1, 95% CI,0.9–1.2). Conclusions Older age, light weight, severer clinical conditions, cognitive impairment, and significantly decreased levels of albumin, RAG, creatinine, uric acid, red blood cell count, hemoglobin, prealbumin, iron, and creatine kinase are more significantly present in patients with SRS compared with those without SRS.
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Affiliation(s)
- Ruihong Yao
- Medical Imaging Department, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Liqing Yao
- Rehabilitation Medicine Department, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
- *Correspondence: Liqing Yao
| | - Amin Rao
- Rehabilitation Medicine Department, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jibing Ou
- Rehabilitation Medicine Department, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Wenli Wang
- Rehabilitation Medicine Department, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Qinzhi Hou
- Rehabilitation Medicine Department, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Chunyan Xu
- Rehabilitation Medicine Department, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Bu-Lang Gao
- Medical Imaging Department, The First Affiliated Hospital of Kunming Medical University, Kunming, China
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15
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Kim S, Yoon HK, Rhee CK, Jung HW, Lee H, Jo YS. Hand Grip Strength and Likelihood of Moderate-to-Severe Airflow Limitation in the General Population. Int J Chron Obstruct Pulmon Dis 2022; 17:1237-1245. [PMID: 35642183 PMCID: PMC9148604 DOI: 10.2147/copd.s364351] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/19/2022] [Indexed: 11/28/2022] Open
Abstract
Background and Objective Sarcopenia is mainly results from aging; however, it is more prevalent in chronic airway disease such as obstructive pulmonary disease (COPD). Hand grip strength (HGS) can be used as an indicator to evaluate sarcopenia. We aimed to assess the association between HGS and severity of airflow limitation (AFL) in the general population. Methods We conducted a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2014 to 2018. Subjects aged ≥40 years who underwent both spirometry and HGS tests were included. AFL was defined by spirometry revealed forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) <0.70). A propensity score-matched comparison was performed, and the risk for moderate-to-very severe AFL was analyzed using logistic regression analysis. Results Among 15,950 subjects, 2277 (14.3%) had AFL with mean FEV1 was 77.1% of the predicted value. Male was predominant in both individuals without AFL and with AFL (74.2% vs 73.5%, p = 0.613). The HGS was 32.9 ± 9.5 kg and 33.3 ± 9.5 kg in participants without AFL and with AFL (p = 0.109). However, HGS was significantly decreased as AFL getting more severe: 34.0 ± 9.6 kg in mild, 33.0 ± 9.5 kg in moderate, and 30.8 ± 8.5 kg in severe to very severe AFL group (p<0.001). As HGS decreased, adjusted odds for moderate-to-very severe AFL increased compared to those with mild AFL (adjusted odds ratio [aOR], 0.97; 95% confidence interval [CI], 0.951–0.987) and both without AFL and mild AFL group (aOR, 0.98; 95% CI, 0.967–0.995) in age-, sex-, and body mass index (BMI)-matched comparisons. Conclusion Lower HGS is significantly associated with moderate-to-very severe AFL in age-, sex-, and BMI-matched comparisons.
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Affiliation(s)
- Sunyoung Kim
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Hyoung Kyu Yoon
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yeouido St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chin Kook Rhee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Yong Suk Jo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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16
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Plasma levels of myokines and inflammatory markers are related with functional and respiratory performance in older adults with COPD and sarcopenia. Exp Gerontol 2022; 164:111834. [PMID: 35588999 DOI: 10.1016/j.exger.2022.111834] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 05/09/2022] [Accepted: 05/11/2022] [Indexed: 11/23/2022]
Abstract
This study investigated whether blood-based biomarkers were related to functional test performance and respiratory muscle strength in older adults with COPD and sarcopenia. The participants included in this cross-sectional study were from both sexes and sixty years or older. Based on clinical assessment, participants were categorized in COPD (n = 43) and non-COPD (NCOPD) (n = 43) groups. They were also assessed for body composition and muscular mass by dual-energy X-ray absorptiometry, using the relative skeletal muscle index for the diagnosis of sarcopenia. A series of functional tests, including short physical performance battery (SPPB), 6-minute walking test (6MWT), maximal inspiratory and expiratory pressures (MIP and MEP), were carried out. Plasma levels of myokines (Irisin and BDNF), and soluble TNF receptors (sTNFR1 and sTNFR2) were determined by ELISA. In the multivariate analysis, 6MWD was associated with age, COPD-related sarcopenia and BDNF (R2 = 0.29; f2 = 0.41). SPPB score was associated with COPD-related sarcopenia and sTNFR1 (R2 = 0.25; f2 = 0.33). MIP value was associated with sex, COPD-related sarcopenia, sTNFR2 and Irisin (R2 = 0.24; f2 = 0.31). Finally, MEP value was associated with sex COPD-related sarcopenia (R2 = 0.18; f2 = 0.22). Plasma levels of myokines and inflammatory markers are related with functional and respiratory performance in older adults with COPD and sarcopenia.
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Usefulness of Body Composition CT Analysis in Patients with Idiopathic Pulmonary Fibrosis: A Pilot Study. Acad Radiol 2022; 29 Suppl 2:S191-S201. [PMID: 34417107 DOI: 10.1016/j.acra.2021.07.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 07/14/2021] [Accepted: 07/21/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE To evaluate the feasibility of a chest CT-based body composition analysis in idiopathic pulmonary fibrosis (IPF), and to investigate the respective contribution of lung and muscle CT quantitative analyses to the prognosis of IPF. METHOD A total of 71 IPF patients were recruited at diagnosis. All patients underwent a standard chest CT-scan and a bioelectrical impedance analysis considered as reference standard for estimating malnutrition through the use of the fat-free mass index (FFMI). The skeletal muscle index (SMI) was measured on chest-CT at the level of the first lumbar vertebra by two radiologists. Lung fibrosis extent was quantified by three radiologists in consensus. The extent of emphysema, the pulmonary artery to aorta (PA/AO) diameter ratio and lymph node enlargement were also reported. Mortality and hospitalization over a 14-month follow-up were recorded. RESULTS A low FFMI defining malnutrition was identified in 26.8% of patients. SMI was significantly lower in these patients (p<0.001) and was correlated with FFMI (r=0.637, p<0.001). Interobserver agreement of SMI measurement was very good (ICC=0.91). For diagnosing malnutrition, SMI showed a 0.79 sensitivity, a 0.69 specificity, a 0.48 PPV and a 0.90 NPV. In univariate analysis, fibrosis extent was significantly associated with death, while SMI did not reach significance. In multivariate analysis, fibrosis extent and PA/AO ratio were independently associated with hospitalization. CONCLUSIONS SMI measured on chest CT could be a reliable tool to exclude malnutrition in IPF. A quantitative analysis of both fibrosis and skeletal muscle may allow holistic management of IPF patients.
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Park HK, Lee SH, Lee SY, Kim SS, Park HW. Relationships between lung function decline and skeletal muscle and fat mass changes: a longitudinal study in healthy individuals. J Cachexia Sarcopenia Muscle 2021; 12:2145-2153. [PMID: 34612015 PMCID: PMC8718064 DOI: 10.1002/jcsm.12821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/17/2021] [Accepted: 08/31/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The associations between long-term changes in body mass composition and decline in lung function in healthy adults are unknown. METHODS Using a well-defined health check-up database, we first assessed individual longitudinal changes in muscle mass (MM) and fat mass (FM) measured via bioelectrical impedance analyses. Then we classified the enrolled individuals into five body composition groups according to their MM index (MMI) [MM (kg)/height (m)2 ] or FM index (FMI) [FM (kg)/height (m)2 ] change rate quartiles. Linear mixed models adjusted for age, smoking status, height, and body mass index were used to analyse the rate of forced expiratory volume in 1 s (FEV1) decline and body composition groups. RESULTS A total of 15 476 middle-aged individuals (6088 women [mean age ± standard deviation: 50.74 ± 7.44] and 9388 men [mean age ± standard deviation: 49.36 ± 6.99]) were enrolled. The mean number of measurements was 6.96 (interquartile range [IQR]: 5-9) over an average follow-up period of 8.95 years (IQR: 6.73-11.10). Decrease in MMI was significantly associated with accelerated FEV1 decline in men only (P = 1.7 × 10-9 ), while increase in FMI was significantly associated with accelerated FEV1 decline in both women and men (P = 7.9 × 10-10 and P < 2.0 × 10-16 respectively). Linear mixed model analyses indicated that annual increase of 0.1 kg/m2 in MMI was related to accelerated FEV1 decline by 30.79 mL/year (95% confidence interval [CI]: 26.10 to 35.48 mL/year) in men. Annual increase of 0.1 kg/m2 in FMI was related to accelerated FEV1 decline by 59.65 mL/year in men (95% CI: 56.84 to 62.28 mL/year) and by 22.84 mL/year in women (95% CI: 18.95 to 26.74 mL/year). In body composition analysis, we found increase in MMI was significantly associated with attenuated FEV1 decline in men only (P = 1.7 × 10-9 ), while increase in FMI was significantly associated with accelerated FEV1 decline in both women and men (P = 7.9 × 10-10 and P < 2.0 × 10-16 respectively). Individuals characterized with gain MM combined with loss of FM were associated with the most favourable outcome (i.e. the smallest rate of decline in FEV1) in both women and men. In men, loss of FM over time is more closely related with attenuated FEV1 decline than change in MM (gain or loss). CONCLUSIONS Change in body composition over time can be used to identify healthy middle-aged individuals at high risk for rapid FEV1 decline.
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Affiliation(s)
- Han-Ki Park
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.,Department of Internal Medicine, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - So-Hee Lee
- Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea
| | - Suh-Young Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sun-Sin Kim
- Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea
| | - Heung-Woo Park
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.,Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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Gungor O, Ulu S, Hasbal NB, Anker SD, Kalantar‐Zadeh K. Effects of hormonal changes on sarcopenia in chronic kidney disease: where are we now and what can we do? J Cachexia Sarcopenia Muscle 2021; 12:1380-1392. [PMID: 34676694 PMCID: PMC8718043 DOI: 10.1002/jcsm.12839] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 09/02/2021] [Accepted: 09/19/2021] [Indexed: 01/06/2023] Open
Abstract
Sarcopenia or muscle wasting is a progressive and generalized skeletal muscle disorder involving the accelerated loss of muscle mass and function, often associated with muscle weakness (dynapenia) and frailty. Whereas primary sarcopenia is related to ageing, secondary sarcopenia happens independent of age in the context of chronic disease states such as chronic kidney disease (CKD). Sarcopenia has become a major focus of research and public policy debate due to its impact on patient's health-related quality of life, health-care expenditure, morbidity, and mortality. The development of sarcopenia in patients with CKD is multifactorial and it may occur independently of weight loss or cachexia including under obese sarcopenia. Hormonal imbalances can facilitate the development of sarcopenia in the general population and is a common finding in CKD. Hormones that may influence the development of sarcopenia are testosterone, growth hormone, insulin, thyroid hormones, and vitamin D. Although the relationship between free testosterone level that is low in uraemic patients and sarcopenia in CKD is not well-defined, functional improvement may be seen. Unlike testosterone, it is known that vitamin D is associated with muscle strength, muscle size, and physical performance in patients with CKD. Outcomes after vitamin D replacement therapy are still controversial. The half-life of growth hormone (GH) is prolonged in patients with CKD. Besides, IGF-1 levels are normal in patients with Stage 4 CKD-a minimal reduction is seen in the end-stage renal disease. Unresponsiveness or resistance of IGF-1 and changes in the GH/IGF-1 axis are the main causes of sarcopenia in CKD. Low serum T3 level is frequent in CKD, but the net effect on sarcopenia is not well-studied. CKD patients develop insulin resistance (IR) from the earliest period even before GFR decline begins. IR reduces glucose utilization as an energy source by hepatic gluconeogenesis, decreasing muscle glucose uptake, impairing intracellular glucose metabolism. This cascade results in muscle protein breakdown. IR and sarcopenia might also be a new pathway for targeting. Ghrelin, oestrogen, cortisol, and dehydroepiandrosterone may be other players in the setting of sarcopenia. In this review, we mainly examine the effects of hormonal changes on the occurrence of sarcopenia in patients with CKD via the available data.
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Affiliation(s)
- Ozkan Gungor
- Division of Nephrology, Department of Internal Medicine, Faculty of MedicineKahramanmaras Sutcu Imam UniversityKahramanmarasTurkey
| | - Sena Ulu
- Department of Internal Medicine and Nephrology, Faculty of MedicineBahcesehir UniversityIstanbulTurkey
| | - Nuri Baris Hasbal
- Clinic of NephrologyBasaksehir Cam and Sakura City HospitalIstanbulTurkey
| | - Stefan D. Anker
- Department of Cardiology (CVK), Berlin Institute of Health Center for Regenerative Therapies (BCRT)German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité Universitätsmedizin BerlinBerlinGermany
| | - Kamyar Kalantar‐Zadeh
- Division of Nephrology, Hypertension and Kidney TransplantationUniversity of California Irvine School of MedicineOrangeCAUSA
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Lage VKDS, de Paula FA, Dos Santos JM, Costa HS, da Silva GP, Lima LP, Santos JNV, de Almeida HC, Figueiredo PHS, Bernardo-Filho M, Taiar R, Teixeira AL, Lacerda ACR, Mendonça VA. Are oxidative stress biomarkers and respiratory muscles strength associated with COPD-related sarcopenia in older adults? Exp Gerontol 2021; 157:111630. [PMID: 34813902 DOI: 10.1016/j.exger.2021.111630] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 11/11/2021] [Accepted: 11/16/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Patients with chronic obstructive pulmonary disease (COPD) often present with sarcopenia, a condition marked by the loss in quality and quantity of muscle mass that can affect the strength of respiratory muscles. COPD and sarcopenia are also independently associated with oxidative stress. This study aimed to investigate whether oxidative stress biomarkers and respiratory muscle strength are associated with sarcopenia in COPD patients. METHODS In a cross-sectional study, 86 elderly subjects, including subjects with and without COPD were assessed for body composition, maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) and oxidative stress parameters [substances reactive to thiobarbituric acid (TBARS), ferric reducing ability of plasma (FRAP), superoxide dismutase (SOD), and catalase (CAT)]. RESULTS The sample was mainly composed by males (72.1%) and eutrophic subjects. COPD-related sarcopenia was evidenced in 51.1% (22/43) of subjects with COPD. The highest TBARS and CAT, and lower MIP and MEP were associated with a high probability of having COPD-related sarcopenia. In the multivariate analysis, TBARS (OR: 4.89, 95% CI 1.52 to 15.54, p = 0.006), CAT (OR: 1.22, 95% CI 1.03 to 1.45, p = 0.020) and MEP (OR: 0.97, 95% CI 0.95 to 0.99, p = 0.020) were independent determinants of COPD-related sarcopenia. CONCLUSION The increase in oxidative stress-related factors and the reduction of respiratory muscle strength are associated with COPD-related sarcopenia.
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Affiliation(s)
- Vanessa Kelly da Silva Lage
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, Sociedade Brasileira de Fisiologia, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil; Laboratório de Inflamação e Metabolismo - LIM, CIPq Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Fabiana Angélica de Paula
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, Sociedade Brasileira de Fisiologia, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil; Laboratório de Inflamação e Metabolismo - LIM, CIPq Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Jousielle Márcia Dos Santos
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, Sociedade Brasileira de Fisiologia, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil; Laboratório de Inflamação e Metabolismo - LIM, CIPq Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Henrique Silveira Costa
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Guilherme Pinto da Silva
- Laboratório de Inflamação e Metabolismo - LIM, CIPq Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil; Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Liliana Pereira Lima
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, Sociedade Brasileira de Fisiologia, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil; Laboratório de Inflamação e Metabolismo - LIM, CIPq Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Joyce Noelly Vítor Santos
- Laboratório de Inflamação e Metabolismo - LIM, CIPq Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil; Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Hellen Cristina de Almeida
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, Sociedade Brasileira de Fisiologia, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil; Laboratório de Inflamação e Metabolismo - LIM, CIPq Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Pedro Henrique Scheidt Figueiredo
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Mario Bernardo-Filho
- Laboratório de Vibrações Mecânicas e Práticas Integrativas, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara Gomes and Policlínica Américo Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Redha Taiar
- MATIM, Moulin de la Housse, Université de Reims Champagne Ardenne, Reims Cedex 2 51687, France
| | - Antônio Lúcio Teixeira
- Instituto de Ensino e Pesquisa Santa Casa BH, Belo Horizonte, Brazil; McGovern Medical School, UT Health Houston, Houston, USA
| | - Ana Cristina Rodrigues Lacerda
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, Sociedade Brasileira de Fisiologia, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil; Laboratório de Inflamação e Metabolismo - LIM, CIPq Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil; Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil; Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Vanessa Amaral Mendonça
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, Sociedade Brasileira de Fisiologia, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil; Laboratório de Inflamação e Metabolismo - LIM, CIPq Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil; Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil; Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil.
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21
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Bhadra R, Bhattacharya S, D'Souza GA, Schols AMWJ, Sambashivaiah S. Pulmonary Rehabilitation in the Management of Chronic Obstructive Pulmonary Disease among Asian Indians- Current Status and Moving Forward. COPD 2021; 18:476-481. [PMID: 34380343 DOI: 10.1080/15412555.2021.1962267] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a significant public health concern in India with high prevalence and associated disability, morbidity, mortality. The progression of COPD is not confined to the lungs but includes extrapulmonary involvement that reduces the functional capacity and quality of life. Pulmonary Rehabilitation (PR) is an evidence-based intervention, targeting multiple domains of pulmonary and extrapulmonary manifestations, and therefore, is recommended as an integral part of COPD management. The practical implementation of PR in India is poor. In this review, we have summarized the latest pieces of evidence in support of PR and highlight the challenges and potential solutions for PR implementation in India.
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Affiliation(s)
- Rohini Bhadra
- St John's Research Institute, St John's Medical College, Bengaluru, India
| | | | - George A D'Souza
- Department of Pulmonary Medicine, St John's Medical College, Bengaluru, India
| | - Annemie M W J Schols
- NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Respiratory Medicine, Maastricht University, Maastricht, The Netherlands
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22
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Ezponda A, Casanova C, Cabrera C, Martin-Palmero Á, Marin-Oto M, Marín JM, Pinto-Plata V, Divo M, Celli BR, Zulueta JJ, Bastarrika G, de-Torres JP. Psoas Muscle Density Evaluated by Chest CT and Long-Term Mortality in COPD Patients. Arch Bronconeumol 2021; 57:533-539. [PMID: 35699031 DOI: 10.1016/j.arbr.2021.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 04/08/2021] [Indexed: 06/15/2023]
Abstract
RATIONALE Poor muscle quality in COPD patients relates to exercise intolerance and mortality. Muscle quality can be estimated on computed tomography (CT) by estimating psoas density (PsD). We tested the hypothesis that PsD is lower in COPD patients than in controls and relates to all-cause mortality. METHODS At baseline, PsD was measured using axial low-dose chest CT images in 220 COPD patients, 80% men, who were 65±8 years old with mild to severe airflow limitation and in a control group of 58 subjects matched by age, sex, body mass index (BMI) and body surface area (BSA). COPD patients were prospectively followed for 76.5 (48-119) months. Anthropometrics, smoking history, BMI, dyspnoea, lung function, exercise capacity, BODE index and exacerbations history were recorded. Cox proportional risk analysis determined the factors more strongly associated with long-term mortality. RESULTS PsD was lower in COPD patients than in controls (40.5 vs 42.5, p=0.045). During the follow-up, 54 (24.5%) deaths occurred in the COPD group. PsD as well as age, sex, pack-year history, FEV1%, 6MWD, mMRC, BODE index, were independently associated with mortality. Multivariate analysis showed that age (HR 1.06; 95% CI 1.02-1.12, p=0.006) and CT-assessed PsD (HR 0.97; 95%CI 0.94-0.99, p=0.023) were the variables independently associated with all-cause mortality. CONCLUSIONS In COPD patients with mild to severe airflow limitation, chest CT-assessed psoas muscle density was lower than in matched controls and independently associated with long-term mortality. Muscle quality using the easy to evaluate psoas muscle density from chest CT may provide clinicians with important prognostic information in COPD.
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Affiliation(s)
- Ana Ezponda
- Radiology Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Ciro Casanova
- Pulmonary Department, Hospital Ntra Sra de Candelaria, Tenerife, Spain; Respiratory Research Unit, Hospital Ntra Sra de Candelaria, Tenerife, Spain
| | - Carlos Cabrera
- Pulmonary Department, Hospital Universitario Doctor Negrín, Las Palmas, Spain
| | | | - Marta Marin-Oto
- Pulmonary Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Jose M Marín
- Pulmonary Department, Hospital Universitario Miguel Servet, Instituto Aragonés Ciencias Salud & CIBERES, Zaragoza, Spain
| | | | - Miguel Divo
- Pulmonary Department, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Bartolome R Celli
- Pulmonary Department, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Javier J Zulueta
- Pulmonary Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Gorka Bastarrika
- Radiology Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Juan P de-Torres
- Respirology and Sleep Division, Queen's University, Kingston, Canada; Pulmonary Department, Clínica Universidad de Navarra, Pamplona, Spain.
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23
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Ko N, Lee HH, Sohn MK, Kim DY, Shin YI, Oh GJ, Lee YS, Joo MC, Lee SY, Song MK, Han J, Ahn J, Lee YH, Chang WH, Choi SM, Lee SK, Lee J, Kim YH. Status of dysphagia after ischemic stroke: A Korean nationwide study. Arch Phys Med Rehabil 2021; 102:2343-2352.e3. [PMID: 34348122 DOI: 10.1016/j.apmr.2021.07.788] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 06/24/2021] [Accepted: 07/01/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To identify the incidence of dysphagia after ischemic stroke and determine factors affecting the presence of dysphagia. DESIGN Retrospective case-control study. This was an interim analysis of a prospective multicenter Korean stroke cohort. SETTING Acute care university hospitals. PARTICIPANTS Patients (N=6000) with first-ever acute ischemic stroke. Patients were divided into two groups according to the presence or absence of dysphagia confirmed at 7 days after onset using the American Speech-Language-Hearing Association National Outcomes Measurement System (ASHA-NOMS) scale, which was determined after conducting screening or standardized tests. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Age at stroke onset, body mass index (BMI), premorbid modified Rankin Scale (mRS), brainstem lesions, National Institutes of Health Stroke Scale (NIHSS), post-stroke mRS, and ASHA-NOMS swallowing level at post-stroke day 7 were evaluated. RESULTS Among ischemic stroke patients, 32.3% (N=1940) had dysphagia at 7 days after stroke onset. At discharge, 80.5% (N=1561) still had dysphagia. The prediction model for the presence of dysphagia identified age at onset, underweight (BMI < 18.5 kg/m2), premorbid mRS, brainstem lesions, and NIHSS as independent predictors. The odds ratio (OR) for the presence of dysphagia significantly increased with underweight (OR [95% confidence interval]: 1.6684 [1.27-2.20]), increased age at onset (1.0318 [1.03-1.04]), premorbid mRS (1.1832 [1.13-1.24]), brainstem lesions (1.6494 [1.39-1.96]), and NIHSS (1.2073 [1.19-1.23]). CONCLUSIONS The incidence of dysphagia after ischemic stroke was 32.3%. The prediction model for the presence of dysphagia identified age, low BMI, premorbid disabilities, brainstem lesions, and NIHSS as predictive factors.
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Affiliation(s)
- Nayeon Ko
- Department of Rehabilitation Medicine, Konkuk University School of Medicine
| | - Hyun Haeng Lee
- Department of Rehabilitation Medicine, Konkuk University School of Medicine
| | - Min Kyun Sohn
- Department of Rehabilitation Medicine, School of Medicine, Chungnam National University
| | - Deog Young Kim
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine
| | - Yong-Il Shin
- Department of Rehabilitation Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital
| | - Gyung-Jae Oh
- Department of Preventive Medicine, Wonkwang University, School of Medicine
| | - Yang-Soo Lee
- Department of Rehabilitation Medicine, Kyungpook National University School of Medicine, Kyungpook National University Hospital
| | - Min Cheol Joo
- Department of Rehabilitation Medicine, Wonkwang University School of Medicine
| | - So Young Lee
- Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine
| | - Min-Keun Song
- Department of Physical and Rehabilitation Medicine, Chonnam National University Medical School
| | - Junhee Han
- Department of Statistics, Hallym University
| | - Jeonghoon Ahn
- Department of Health Convergence, Ewha Womans University
| | - Young-Hoon Lee
- Department of Preventive Medicine, Wonkwang University, School of Medicine
| | - Won Hyuk Chang
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Soo Mi Choi
- Korea Centers for Disease Control and Prevention, Division of Chronic Disease Prevention, Center for Disease
| | - Seon Kui Lee
- Korea Centers for Disease Control and Prevention, Division of Chronic Disease Prevention, Center for Disease
| | - Jongmin Lee
- Department of Rehabilitation Medicine, Konkuk University School of Medicine.
| | - Yun-Hee Kim
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine; Department of Health Science and Technology, Department of Medical Device Management and Research, Department of Digital Healthcare, SAIHST, Sungkyunkwan University.
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24
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Choi YJ, Kwon DS, Kim T, Cho JH, Kim HJ, Byun MK, Park HJ. Low alanine aminotransferase as a risk factor for chronic obstructive pulmonary disease in males. Sci Rep 2021; 11:14829. [PMID: 34290312 PMCID: PMC8295341 DOI: 10.1038/s41598-021-94385-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 07/05/2021] [Indexed: 11/25/2022] Open
Abstract
Alanine aminotransferase (ALT) levels reflect skeletal muscle volume and general performance, which are associated with chronic obstructive pulmonary disease (COPD) development and prognosis. This study aimed to investigate ALT levels as a risk factor for COPD development. This 13-year population-based retrospective observational cohort study included 422,452 participants for analysis. We classified groups according to the baseline ALT levels (groups 1-5: ALT (IU/L) < 10; 10-19; 20-29; 30-39; and ≥ 40, respectively). The incidence of COPD was the highest in group 1, decreasing as the group number increased in males, but not in females. The Cox regression analysis in males revealed that a lower ALT level, as a continuous variable, was a significant risk factor for COPD development [univariable, hazard ratio (HR): 0.992, 95% confidence interval (CI): 0.991-0.994; multivariable, HR: 0.998, 95% CI: 0.996-0.999]. In addition, COPD was more likely to develop in the lower ALT level groups (groups 1-4; < 40 IU/L), than in the highest ALT level group (group 5; ≥ 40 IU/L) (univariable, HR: 1.341, 95% CI: 1.263-1.424; multivariable, HR: 1.097, 95% CI: 1.030-1.168). Our findings suggest that males with low ALT levels should be carefully monitored for COPD development.
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Affiliation(s)
- Yong Jun Choi
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonju-ro, Gangnam-gu, Seoul, 06273, Korea
| | - Do Sun Kwon
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonju-ro, Gangnam-gu, Seoul, 06273, Korea
| | - Taehee Kim
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonju-ro, Gangnam-gu, Seoul, 06273, Korea
| | - Jae Hwa Cho
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonju-ro, Gangnam-gu, Seoul, 06273, Korea
| | - Hyung Jung Kim
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonju-ro, Gangnam-gu, Seoul, 06273, Korea
| | - Min Kwang Byun
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonju-ro, Gangnam-gu, Seoul, 06273, Korea
| | - Hye Jung Park
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonju-ro, Gangnam-gu, Seoul, 06273, Korea.
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25
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Machado FVC, Spruit MA, Coenjaerds M, Pitta F, Reynaert NL, Franssen FME. Longitudinal changes in total and regional body composition in patients with chronic obstructive pulmonary disease. Respirology 2021; 26:851-860. [PMID: 34131996 PMCID: PMC8453699 DOI: 10.1111/resp.14100] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 03/30/2021] [Accepted: 05/18/2021] [Indexed: 01/03/2023]
Abstract
Background and objective Low fat‐free mass (FFM) is common in patients with chronic obstructive pulmonary disease (COPD) and contributes to morbidity and mortality. Few studies have evaluated longitudinal changes in body composition in patients with COPD compared with non‐COPD controls. This study aimed to compare longitudinal changes in total and regional body composition between patients with COPD and non‐COPD controls and investigate predictors of changes in body composition in COPD. Methods Patients with COPD and non‐COPD controls participating in the Individualized COPD Evaluation in relation to Ageing (ICE‐Age) study, a single‐centre, longitudinal, observational study, were included. Subjects were assessed at baseline and after 2 years of follow‐up. Among other procedures, body composition was measured by dual‐energy X‐ray absorptiometry scan. The number of exacerbations/hospitalizations 1 year before inclusion and during follow‐up were assessed in patients with COPD. Results A total of 405 subjects were included (205 COPD, 87 smoking and 113 non‐smoking controls). Patients with COPD and smoking controls presented a significant decline in total FFM (mean [95% CI]: −1173 [−1527/−820] g and −486 [−816/−156] g, respectively) while body composition remained stable in non‐smoking controls. In patients with COPD, the decline in FFM was more pronounced in legs (−174 [−361/14] g) and trunk (−675 [−944/406] g) rather than in arms (54 [−19/126] g). The predictors of changes in total and regional FFM in patients with COPD were gender, number of previous hospitalizations, baseline values of FFM and BMI. Conclusion Patients with COPD present a significant decline in FFM after 2 years of follow‐up, this decline is more pronounced in their legs and trunk. Patients with chronic obstructive pulmonary disease (COPD) present a significant decline in total, leg and trunk low fat‐free mass (FFM), while arms FFM remains stable after 2 years of follow‐up. We identified a subgroup of patients with preserved FFM at baseline and history of previous hospitalizations that present greater decline in total and leg FFM compared to other patients with COPD. See relatedEditorial
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Affiliation(s)
- Felipe V C Machado
- Department of Research and Development, Ciro - Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands.,School of Nutrition and Translational Research in Metabolism, NUTRIM, Maastricht, The Netherlands.,Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.,Laboratory of Research in Respiratory Physiotherapy, Department of Physical Therapy, State University of Londrina, Londrina, Brazil
| | - Martijn A Spruit
- Department of Research and Development, Ciro - Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands.,School of Nutrition and Translational Research in Metabolism, NUTRIM, Maastricht, The Netherlands.,Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
| | - Miranda Coenjaerds
- Department of Dietetics, Ciro - Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands
| | - Fabio Pitta
- Laboratory of Research in Respiratory Physiotherapy, Department of Physical Therapy, State University of Londrina, Londrina, Brazil
| | - Niki L Reynaert
- School of Nutrition and Translational Research in Metabolism, NUTRIM, Maastricht, The Netherlands.,Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
| | - Frits M E Franssen
- Department of Research and Development, Ciro - Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands.,School of Nutrition and Translational Research in Metabolism, NUTRIM, Maastricht, The Netherlands.,Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
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26
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Effect of Vitamin D Supplementation on Skeletal Muscle Volume and Strength in Patients with Decompensated Liver Cirrhosis Undergoing Branched Chain Amino Acids Supplementation: A Prospective, Randomized, Controlled Pilot Trial. Nutrients 2021; 13:nu13061874. [PMID: 34070910 PMCID: PMC8228227 DOI: 10.3390/nu13061874] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Sarcopenia worsens patient prognoses in chronic liver disease. This study aimed to elucidate the effects of vitamin D supplementation on skeletal muscle volume and strength in patients with decompensated cirrhosis. METHODS Thirty-three patients were entered into the study based on the criteria and then randomly assigned to two groups: Group A (n = 17), the control group, and Group B (n = 16), those who received oral native vitamin D3 at a dose of 2000 IU once a day for 12 months. RESULTS SMI values in Group B were significantly increased at 12 months (7.64 × 10-3). The extent of changes in the SMI and grip strength in Group B were significantly greater than that in Group A at 12 months (p = 2.57 × 10-3 and 9.07 × 10-3). The median change rates in the SMI were +5.8% and the prevalence of sarcopenia was significantly decreased from 80.0% (12/15) to 33.3% (5/15; p = 2.53 × 10-2) in Group B. CONCLUSIONS Vitamin D supplementation might be an effective and safe treatment option for patients with decompensated cirrhosis to increase or restore the skeletal muscle volume and strength or prevent the muscle volume and strength losses.
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27
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Ezponda A, Casanova C, Cabrera C, Martin-Palmero Á, Marin-Oto M, Marín JM, Pinto-Plata V, Divo M, Celli BR, Zulueta JJ, Bastarrika G, de-Torres JP. Psoas Muscle Density Evaluated by Chest CT and Long-Term Mortality in COPD Patients. Arch Bronconeumol 2021; 57:S0300-2896(21)00133-2. [PMID: 33994243 DOI: 10.1016/j.arbres.2021.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 04/01/2021] [Accepted: 04/08/2021] [Indexed: 10/21/2022]
Abstract
RATIONALE Poor muscle quality in COPD patients relates to exercise intolerance and mortality. Muscle quality can be estimated on computed tomography (CT) by estimating psoas density (PsD). We tested the hypothesis that PsD is lower in COPD patients than in controls and relates to all-cause mortality. METHODS At baseline, PsD was measured using axial low-dose chest CT images in 220 COPD patients, 80% men, who were 65±8 years old with mild to severe airflow limitation and in a control group of 58 subjects matched by age, sex, body mass index (BMI) and body surface area (BSA). COPD patients were prospectively followed for 76.5 (48-119) months. Anthropometrics, smoking history, BMI, dyspnoea, lung function, exercise capacity, BODE index and exacerbations history were recorded. Cox proportional risk analysis determined the factors more strongly associated with long-term mortality. RESULTS PsD was lower in COPD patients than in controls (40.5 vs 42.5, p=0.045). During the follow-up, 54 (24.5%) deaths occurred in the COPD group. PsD as well as age, sex, pack-year history, FEV1%, 6MWD, mMRC, BODE index, were independently associated with mortality. Multivariate analysis showed that age (HR 1.06; 95% CI 1.02-1.12, p=0.006) and CT-assessed PsD (HR 0.97; 95%CI 0.94-0.99, p=0.023) were the variables independently associated with all-cause mortality. CONCLUSIONS In COPD patients with mild to severe airflow limitation, chest CT-assessed psoas muscle density was lower than in matched controls and independently associated with long-term mortality. Muscle quality using the easy to evaluate psoas muscle density from chest CT may provide clinicians with important prognostic information in COPD.
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Affiliation(s)
- Ana Ezponda
- Radiology Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Ciro Casanova
- Pulmonary Department, Hospital Ntra Sra de Candelaria, Tenerife, Spain; Respiratory Research Unit, Hospital Ntra Sra de Candelaria, Tenerife, Spain
| | - Carlos Cabrera
- Pulmonary Department, Hospital Universitario Doctor Negrín, Las Palmas, Spain
| | | | - Marta Marin-Oto
- Pulmonary Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Jose M Marín
- Pulmonary Department, Hospital Universitario Miguel Servet, Instituto Aragonés Ciencias Salud & CIBERES, Zaragoza, Spain
| | | | - Miguel Divo
- Pulmonary Department, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Bartolome R Celli
- Pulmonary Department, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Javier J Zulueta
- Pulmonary Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Gorka Bastarrika
- Radiology Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Juan P de-Torres
- Respirology and Sleep Division, Queen's University, Kingston, Canada; Pulmonary Department, Clínica Universidad de Navarra, Pamplona, Spain.
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Katsuki M, Kakizawa Y, Nishikawa A, Yamamoto Y, Uchiyama T. Temporal muscle thickness and area are an independent prognostic factors in patients aged 75 or younger with aneurysmal subarachnoid hemorrhage treated by clipping. Surg Neurol Int 2021; 12:151. [PMID: 33948321 PMCID: PMC8088495 DOI: 10.25259/sni_814_2020] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 03/16/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Skeletal muscle mass is an important factor for various diseases' outcomes. As for its indicators, temporal muscle thickness (TMT) and temporal muscle area (TMA) on the head computed tomography are useful, and TMT and TMA were reported as potential prognostic factors for aneurysmal subarachnoid hemorrhage (SAH). We examined the clinical characteristics, including TMT and TMA, of SAH patients aged 75 or younger. METHODS We retrospectively investigated 127 SAH patients with all World Federation of Neurosurgical Societies (WFNS) grades and treated by clipping between 2009 and 2019. Clinical outcome was measured with the modified Rankin Scale (mRS) at 6 months, with favorable outcome defined as mRS 0-2. The associations between the clinical variables and the outcomes were analyzed. RESULTS The mean age was 60.6 (32-74) years, and 65% were women. The mean ± standard deviation of WFNS grade was 2.8 ± 1.4. TMT and TMA were larger in the favorable outcome group than the poor one. Multivariate analysis revealed that age, smoking, WFNS grade, and TMT or TMA were associated with favorable outcome. Receiver operating characteristic analysis found that the threshold of TMT was 4.9 mm in female and 6.7 mm in male, and that of TMA was 193 mm2 in female and 333 mm2 in male. CONCLUSION The odds ratios for TMT and TMA related to clinical outcome were lower than for smoking and WFNS grade; however, on multivariate analysis they remained independent prognostic factors in SAH patients aged 75 or younger treated by clipping. Further studies are needed to confirm these findings.
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Affiliation(s)
| | - Yukinari Kakizawa
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa, Nagano, Japan
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29
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Benlala I, Laurent F, Dournes G. Structural and functional changes in COPD: What we have learned from imaging. Respirology 2021; 26:731-741. [PMID: 33829593 DOI: 10.1111/resp.14047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is the third leading cause of mortality worldwide. It is a heterogeneous disease involving different components of the lung to varying extents. Developments in medical imaging and image analysis techniques provide new insights in the assessment of the structural and functional changes of the disease. This article reviews the leading imaging techniques: CT and MRI of the lung in research settings and clinical routine. Both visual and quantitative methods are reviewed, emphasizing their relevance to patient phenotyping and outcome prediction.
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Affiliation(s)
- Ilyes Benlala
- Centre de recherche Cardio-Thoracique de Bordeaux, University of Bordeaux, INSERM, Bordeaux, France
| | - François Laurent
- Centre de recherche Cardio-Thoracique de Bordeaux, University of Bordeaux, INSERM, Bordeaux, France
| | - Gael Dournes
- Centre de recherche Cardio-Thoracique de Bordeaux, University of Bordeaux, INSERM, Bordeaux, France
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30
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Zhang JX, Li J, Chen C, Yin T, Wang QA, Li XX, Wang FX, Zhao JH, Zhao Y, Zhang YH. Reference values of skeletal muscle mass, fat mass and fat-to-muscle ratio for rural middle age and older adults in western China. Arch Gerontol Geriatr 2021; 95:104389. [PMID: 33713879 DOI: 10.1016/j.archger.2021.104389] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/02/2021] [Accepted: 03/03/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Skeletal muscle mass (SMM), fat mass (FM) and fat-to-muscle ratio (FMR) are significant indicators in epidemiology studies and clinical settings. The aim of this study was to establish age-related and sex-specific reference values for skeletal muscle mass index (SMMI), fat mass index (FMI) and FMR by bioelectrical impedance analysis (BIA) for healthy rural adults in western China. METHODS This study is a cross-sectional study from Ningxia cohort study, included 13,790 individuals aged 35 to 74 years. Bioelectrical impedance analysis (BIA) was performed to measure body composition. Lambda-mu-sigma method was used to establish age-related and sex-specific percentile curves for SMMI, FMI and FMR. RESULTS Overall, men had higher SMMI, but lower FMI and FMR than women for all ages. The SMMI decreased rapidly with age for men and women after 55 years and 45 years, respectively. FMI in men remain stable until 70 years; women's FMI showed a rapidly increasing after 50 years. The FMR increased consistently after 35 years for both men and women. These age-related and sex-specific reference values were established with the mean ± SD as the normal reference range. CONCLUSIONS These reference values could be used as simple tools to identify age-specific low SMMI or high FMI and facilitate earlier identification sarcopenia or sarcopenic obesity in rural Chinese adults.
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Affiliation(s)
- Jia-Xing Zhang
- School of Public Health and Management, Ningxia Medical University, Ningxia Hui Autonomous Region, China
| | - Juan Li
- School of Public Health and Management, Ningxia Medical University, Ningxia Hui Autonomous Region, China
| | - Chen Chen
- School of Public Health and Management, Ningxia Medical University, Ningxia Hui Autonomous Region, China
| | - Ting Yin
- School of Public Health and Management, Ningxia Medical University, Ningxia Hui Autonomous Region, China
| | - Qing-An Wang
- School of Public Health and Management, Ningxia Medical University, Ningxia Hui Autonomous Region, China
| | - Xiao-Xia Li
- School of Public Health and Management, Ningxia Medical University, Ningxia Hui Autonomous Region, China
| | - Fa-Xuan Wang
- School of Public Health and Management, Ningxia Medical University, Ningxia Hui Autonomous Region, China
| | - Jian-Hua Zhao
- The Ningxia Hui Autonomous Region Center for Disease Control and Prevention, Ningxia Hui Autonomous Region, China
| | - Yi Zhao
- School of Public Health and Management, Ningxia Medical University, Ningxia Hui Autonomous Region, China.
| | - Yu-Hong Zhang
- School of Public Health and Management, Ningxia Medical University, Ningxia Hui Autonomous Region, China.
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31
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Zuberi FF, Zuberi BF, Ali FS, Bader N. Muscle weakness assessment in non-hypoxemic COPD out-patients at tertiary care hospitals. Pak J Med Sci 2021; 37:536-542. [PMID: 33679946 PMCID: PMC7931309 DOI: 10.12669/pjms.37.2.3127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: To determine frequency of Muscle Weakness in Non-Hypoxemic COPD out-patients and Comparison with age matched non-COPD Controls. Methods: This cross-sectional study was conducted at OPD of Ojha Institute of Chest Diseases and Medicine, Dow University of Health Sciences, Karachi, Pakistan, during the period 8th September 2019 till 30th May 2020. Patients of both genders aged 25-70 years who were satisfying GOLD criteria for COPD and having SpO2 ≥ 94% were included. An age matched control group was added as control. Hand Grip Strength (HGS) and Chair to Stand time (CST) were recorded. Results: Two hundred fifty-six patients were inducted with aged and BMI matched group of non-COPD Control patients in ratio of 1:2 (n = 128). Comparison of HGS between Control and COPD Groups showed significant weakness in COPD group. Significant weakness in lower limbs in COPD Group with longer timings to complete the task. Mean FEV1 had significant low values in COPD Group. Age correlated negatively with HGS & positively with CST. BMI correlated positively with FEV1 and CST but negatively with HGS. HGS correlated positively with FEV1 and no correlation was found with CST. No correlation was found of CST with FEV1. Conclusion: Muscle weakness in COPD patients was shown by simple validated bedside tools. The older COPD patients had less HGS and were slower in doing CST whereas those COPD ones who had higher FEV1 had more HGS.
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Affiliation(s)
- Faisal Faiyaz Zuberi
- Faisal Faiyaz Zuberi, Ojha Institute of Chest Diseases, Dow University of Health Sciences, Karachi, Pakistan
| | - Bader Faiyaz Zuberi
- Bader Faiyaz Zuberi, Department of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Faiza Sadaqat Ali
- Faiza Sadaqat Ali, Department of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Nimrah Bader
- Nimrah Bader, Department of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Mostarda C, Barboza CDA, Cutrim AL, Silva-Filho AC, Dias CJ, Brito-Monzani JDO, Rodrigues B. Obesity as an additional factor for autonomic imbalance and poor sleep behavior in chronic obstructive pulmonary disease: a case-control study. Clinics (Sao Paulo) 2021; 76:e1826. [PMID: 33503172 PMCID: PMC7798128 DOI: 10.6061/clinics/2021/e1826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 09/02/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES We compared the autonomic modulation and sleep behavior of eutrophic and overweight patients with chronic obstructive pulmonary disease (COPD). METHODS COPD participants were divided into the overweight and eutrophic groups. Pulmonary function, blood pressure, body composition, autonomic modulation, and the Pittsburgh Sleep Quality Index score were assessed. Participants performed the six-minute walk test for functional assessment. RESULTS Spirometric variables obtained in eutrophic and overweight individuals with COPD showed no statistically different results. We observed that the SDNN index indicated lower overall variability (p=0.003), and root mean square of successive differences between normal heart beats (RMSSD) (p=0.04) indicated lower parasympathetic modulation in the overweight group than observed in the eutrophic group. The indexes of the frequency domain presented lower values of total variability (p<0.01), low frequency bands (p<0.01), and high frequency (p=0.02), suggesting a higher sympathetic modulation and reduced parasympathetic modulation of the overweight group compared to eutrophic group. The overweight group also showed reduced sleep quality than the eutrophic group. CONCLUSION Overweight COPD patients showed lower autonomic modulation and impaired sleep quality, latency, and efficiency as compared eutrophic subjects. These results reinforce the importance of weight control and the acquisition of healthy habits in this population.
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Affiliation(s)
- Cristiano Mostarda
- Laboratorio de Adaptacoes Cardiovasculares ao Exercicio (LACORE), Universidade Federal do Maranhao, Sao Luis, MA, BR
- Programa de Pos-Graduacao em Educacao Fisica, Universidade Federal do Maranhao, Sao Luis, MA, BR
- Centro de Reabilitacao Cardiopulmonar, Hospital Universitario “Presidente Dutra”, Universidade Federal do Maranhao, Sao Luis, MA, BR
| | | | - Ana Lídia Cutrim
- Laboratorio de Adaptacoes Cardiovasculares ao Exercicio (LACORE), Universidade Federal do Maranhao, Sao Luis, MA, BR
- Programa de Pos-Graduacao em Educacao Fisica, Universidade Federal do Maranhao, Sao Luis, MA, BR
| | - Antonio Carlos Silva-Filho
- Laboratorio de Adaptacoes Cardiovasculares ao Exercicio (LACORE), Universidade Federal do Maranhao, Sao Luis, MA, BR
- Programa de Pos-Graduacao em Educacao Fisica, Universidade Federal do Maranhao, Sao Luis, MA, BR
| | - Carlos José Dias
- Laboratorio de Adaptacoes Cardiovasculares ao Exercicio (LACORE), Universidade Federal do Maranhao, Sao Luis, MA, BR
- Centro de Reabilitacao Cardiopulmonar, Hospital Universitario “Presidente Dutra”, Universidade Federal do Maranhao, Sao Luis, MA, BR
| | - Janaina De Oliveira Brito-Monzani
- Laboratorio de Adaptacoes Cardiovasculares ao Exercicio (LACORE), Universidade Federal do Maranhao, Sao Luis, MA, BR
- Programa de Pos-Graduacao em Educacao Fisica, Universidade Federal do Maranhao, Sao Luis, MA, BR
| | - Bruno Rodrigues
- Faculdade de Educacao Fisica, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, BR
- *Corresponding author. E-mail:
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Lage VKS, Silva GP, Lacerda ACR, Paula FA, Lima LP, Santos JNV, Almeida HC, Pinto AGF, Figueiredo PHS, Costa HS, Bernardo-Filho M, Sá-Caputo DC, Taiar R, Leite HR, Teixeira AL, Mendonça VA. Functional tests associated with sarcopenia in moderate chronic obstructive pulmonary disease. Expert Rev Respir Med 2020; 15:569-576. [PMID: 33197358 DOI: 10.1080/17476348.2021.1850276] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Objectives: To evaluate the association of physical and functional measures with sarcopenia in moderate chronic obstructive pulmonary disease (COPD) and to establish cutoff points for sarcopenia screening.Methods: The study included COPD with and without sarcopenia, of both sexes who were over 50 years old. Participants were assessed for lung function, body composition, grip strength, Short Physical Performance Battery (SPPB), 5-repetition, 10-repetition and 30-s sit-to-stand tests (5STS, 10STS, and 30STS, respectively). In addition, 6-min walking test, respiratory muscular strength, and physical activity level were tested.Results: The study had 35 participants, 24 men (68.6%) and moderate COPD (51.4%). COPD-sarcopenia showed lower values in lean mass, body fat and body mass alongside lower performance in 10 and 30 STS tests, SPPB and gait speed compared to non-sarcopenic group. The cutoff points with better sensitivity and specificity to identify sarcopenia were 10.88 and 34.14 s, 15 repetitions, and 10 points in the 5STS, 10STS, 30STS, and SPPB, respectively. The comparison of the receiver operating curves evidenced no differences between the functional tests. Only 30STS and SPPB showed acceptable discriminatory power.Conclusion: Functional tests, especially 30STS and SPPB, are simple and affordable tools for screening sarcopenia in COPD with moderate obstruction.
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Affiliation(s)
- V K S Lage
- Programa Multicêntrico De Pós-Graduação Em Ciências Fisiológicas, Sociedade Brasileira De Fisiologia, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil.,Laboratório De Inflamação E Metabolismo - LIM, CIPq Saúde, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil
| | - G P Silva
- Laboratório De Inflamação E Metabolismo - LIM, CIPq Saúde, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil.,Programa De Pós-Graduação Em Reabilitação E Desempenho Funcional, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil
| | - A C R Lacerda
- Programa Multicêntrico De Pós-Graduação Em Ciências Fisiológicas, Sociedade Brasileira De Fisiologia, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil.,Laboratório De Inflamação E Metabolismo - LIM, CIPq Saúde, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil.,Programa De Pós-Graduação Em Reabilitação E Desempenho Funcional, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil.,Departamento De Fisioterapia, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil
| | - F A Paula
- Programa Multicêntrico De Pós-Graduação Em Ciências Fisiológicas, Sociedade Brasileira De Fisiologia, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil.,Laboratório De Inflamação E Metabolismo - LIM, CIPq Saúde, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil
| | - L P Lima
- Programa Multicêntrico De Pós-Graduação Em Ciências Fisiológicas, Sociedade Brasileira De Fisiologia, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil.,Laboratório De Inflamação E Metabolismo - LIM, CIPq Saúde, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil
| | - J N V Santos
- Laboratório De Inflamação E Metabolismo - LIM, CIPq Saúde, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil.,Programa De Pós-Graduação Em Reabilitação E Desempenho Funcional, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil
| | - H C Almeida
- Programa Multicêntrico De Pós-Graduação Em Ciências Fisiológicas, Sociedade Brasileira De Fisiologia, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil.,Laboratório De Inflamação E Metabolismo - LIM, CIPq Saúde, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil
| | - A G F Pinto
- Laboratório De Inflamação E Metabolismo - LIM, CIPq Saúde, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil
| | - P H S Figueiredo
- Programa De Pós-Graduação Em Reabilitação E Desempenho Funcional, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil.,Departamento De Fisioterapia, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil
| | - H S Costa
- Departamento De Fisioterapia, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil
| | - M Bernardo-Filho
- Laboratório De Vibrações Mecânicas E Práticas Integrativas, Departamento De Biofísica E Biometria, Instituto De Biologia Roberto Alcântara Gomes and Policlínica Américo Piquet Carneiro, Universidade Do Estado Do Rio De Janeiro, Rio De Janeiro, Brasil
| | - D C Sá-Caputo
- Laboratório De Vibrações Mecânicas E Práticas Integrativas, Departamento De Biofísica E Biometria, Instituto De Biologia Roberto Alcântara Gomes and Policlínica Américo Piquet Carneiro, Universidade Do Estado Do Rio De Janeiro, Rio De Janeiro, Brasil
| | - R Taiar
- GRESPI, Université De Reims, Reims, France
| | - H R Leite
- Programa Multicêntrico De Pós-Graduação Em Ciências Fisiológicas, Sociedade Brasileira De Fisiologia, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil.,Laboratório De Inflamação E Metabolismo - LIM, CIPq Saúde, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil.,Programa De Pós-Graduação Em Reabilitação E Desempenho Funcional, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil.,Departamento De Fisioterapia, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil
| | - A L Teixeira
- Instituto De Ensino E Pesquisa Santa Casa BH, Belo Horizonte, Brazil.,McGovern Medical School, UT Health Houston, Houston, TX, USA
| | - V A Mendonça
- Programa Multicêntrico De Pós-Graduação Em Ciências Fisiológicas, Sociedade Brasileira De Fisiologia, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil.,Laboratório De Inflamação E Metabolismo - LIM, CIPq Saúde, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil.,Programa De Pós-Graduação Em Reabilitação E Desempenho Funcional, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil.,Departamento De Fisioterapia, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Brasil
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Tsekoura M, Tsepis E, Billis E, Gliatis J. Sarcopenia in patients with chronic obstructive pulmonary disease: A study of prevalence and associated factors in Western Greek population. Lung India 2020; 37:479-484. [PMID: 33154208 PMCID: PMC7879857 DOI: 10.4103/lungindia.lungindia_143_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is associated with a progressive loss of muscle mass and function and a systemic inflammatory process that can cause sarcopenia. Objective: The objective of this study is to estimate the prevalence rate of sarcopenia in COPD patients and to determine the factors associated with sarcopenic patients living in Western Greece. Methods: European Working Group on Sarcopenia in Older People criteria were applied to 69 outpatients with stable COPD. Body composition, exercise capacity, functional performance, physical activity, and health status were also assessed. COPD disease severity (COPD stage) was evaluated with the Global Initiative for chronic obstructive lung disease. The study protocol was approved by the Ethical Committee of the Technological Educational Institute of Western Greece. Results: The sample comprised 69 patients (59 women and 10 men), with a mean age of 71.33 ± 7.48 years. The prevalence of sarcopenia was 24.6% (n = 17). A high percentage (82.6%; n = 57) of the 69 Greek participants did not perform any regular exercise. The findings of this study demonstrated that sarcopenia was positively associated with COPD, age, body mass index, skeletal muscle mass, hand grip strength, and 4 m test. Conclusions: In conclusion, there is a 24.6% prevalence of sarcopenia in patients with COPD. Further research with larger samples would be indicated to clarify the precise association of specific characteristics of patients with sarcopenia and COPD.
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Affiliation(s)
- Maria Tsekoura
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Patras, Greece
| | - Elias Tsepis
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Patras, Greece
| | - Evdokia Billis
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Patras, Greece
| | - John Gliatis
- Department of Medicine, School of Health Sciences, University of Patras, Patras, Greece
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Ozcakir S, Sigirli D, Ursavas A, Uzaslan E. COPD and Osteoporosis: Associated Factors in Patients Treated with Inhaled Corticosteroids. Int J Chron Obstruct Pulmon Dis 2020; 15:2441-2448. [PMID: 33116459 PMCID: PMC7553256 DOI: 10.2147/copd.s274728] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 09/23/2020] [Indexed: 12/19/2022] Open
Abstract
Purpose Osteoporosis is a systemic skeletal disease with a consequent increase in fractures rates. Osteoporosis may be primary which is related with normal aging, or secondary which occurs in the presence of an underlying disease or medication. Osteoporosis is one of the significant comorbidities in chronic obstructive pulmonary disease (COPD). In this study, we aimed to investigate the presence of osteoporosis and the influencing factors in COPD patients. Patients and Methods This is a two-group comparison study that was conducted among 30 COPD patients on inhaled corticosteroid (ICS) and 33 controls. It was conducted in the outpatient clinics at the Departments of Physical Medicine and Rehabilitation and Pulmonary Diseases in Bursa Uludag University Hospital, a tertiary reference center, in the northwest region of Turkey. For both groups, demographic variables, osteoporosis risk questioning, body mass index (BMI), bone mineral density (BMD), biochemical blood tests, vertebral fractures on lumbar and thoracic x-rays were recorded. COPD patients were also evaluated for lung functions via spirometry. Results Thirty patients with COPD (Group 1) and 33 controls (Group 2) were included in the study. Comparing the demographic and biochemical data, no difference was found between the groups except smoking (pack/year) (p<0.001) and erythrocyte sedimentation rate (p<0.001), which were significantly high in COPD group. BMD in the COPD group was significantly lower in both hip and lumbar regions compared with the controls. There were significant correlations between L2 BMD values and pulmonary function tests. BMI was significantly low in osteoporotic COPD patients when compared with the non-osteoporotic COPD patients (p=0.002). Conclusion In patients with COPD using inhaled corticosteroids, BMD was significantly low compared with the controls. Osteoporotic COPD patients had significantly lower BMI than non-osteoporotic. These findings suggest that pulmonary dysfunction and low BMI are associated with osteoporosis in COPD patients.
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Affiliation(s)
- Suheda Ozcakir
- Department of Physical Medicine and Rehabilitation, Bursa Uludag University, Faculty of Medicine, Bursa, Turkey
| | - Deniz Sigirli
- Department of Biostatistics, Bursa Uludag University, Faculty of Medicine, Bursa, Turkey
| | - Ahmet Ursavas
- Department of Pulmonary Diseases, Bursa Uludag University, Faculty of Medicine, Bursa, Turkey
| | - Esra Uzaslan
- Department of Pulmonary Diseases, Bursa Uludag University, Faculty of Medicine, Bursa, Turkey
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Sepúlveda‐Loyola W, Osadnik C, Phu S, Morita AA, Duque G, Probst VS. Diagnosis, prevalence, and clinical impact of sarcopenia in COPD: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2020; 11:1164-1176. [PMID: 32862514 PMCID: PMC7567149 DOI: 10.1002/jcsm.12600] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 06/06/2020] [Accepted: 06/10/2020] [Indexed: 12/17/2022] Open
Abstract
Sarcopenia prevalence and its clinical impact are reportedly variable in chronic obstructive pulmonary disease (COPD) due partly to definition criteria. This review aimed to identify the criteria used to diagnose sarcopenia and the prevalence and impact of sarcopenia on health outcomes in people with COPD. This review was registered in PROSPERO (CRD42018092576). Five electronic databases were searched to August 2018 to identify studies related to sarcopenia and COPD. Study quality was assessed using validated instruments matched to study designs. Sarcopenia prevalence was determined using authors' definitions. Comparisons were made between people who did and did not have sarcopenia for pulmonary function, exercise capacity, quality of life, muscle strength, gait speed, physical activity levels, inflammation/oxidative stress, and mortality. Twenty-three studies (70% cross-sectional) from Europe (10), Asia (9), and North and South America (4) involving 9637 participants aged ≥40 years were included (69.5% men). Sarcopenia criteria were typically concordant with recommendations of hEuropean and Asian consensus bodies. Overall sarcopenia prevalence varied from 15.5% [95% confidence interval (CI) 11.8-19.1; combined muscle mass, strength, and/or physical performance criteria] to 34% (95%CI 20.6-47.3; muscle mass criteria alone) (P = 0.009 between subgroups) and was greater in people with more severe [37.6% (95%CI 24.8-50.4)] versus less severe [19.1% (95%CI 10.2-28.0)] lung disease (P = 0.020), but similar between men [41.0% (95%CI 26.2-55.9%)] and women [31.9% (95%CI 7.0-56.8%)] (P = 0.538). People with sarcopenia had lower predicted forced expiratory volume in the first second (mean difference -7.1%; 95%CI -9.0 to -5.1%) and poorer exercise tolerance (standardized mean difference -0.8; 95%CI -1.4 to -0.2) and quality of life (standardized mean difference 0.26; 95%CI 0.2-0.4) compared with those who did not (P < 0.001 for all). No clear relationship was observed between sarcopenia and inflammatory or oxidative stress biomarkers. Incident mortality was unreported in the literature. Sarcopenia is prevalent in a significant proportion of people with COPD and negatively impacts upon important clinical outcomes. Opportunities exist to optimize its early detection and management and to evaluate its impact on mortality in this patient group.
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Affiliation(s)
- Walter Sepúlveda‐Loyola
- Department of PhysiotherapyLondrina State UniversityLondrinaParanáBrazil
- Centre of Research and Post‐Graduation in Health Sciences (CEPPOS)Londrina State UniversityLondrinaParanáBrazil
- Department of Medicine—Western Health, Melbourne Medical SchoolThe University of MelbourneSt AlbansVICAustralia
- Australian Institute for Musculoskeletal Science (AIMSS)University of Melbourne and Western HealthSt AlbansVICAustralia
| | - Christian Osadnik
- Department of PhysiotherapyMonash UniversityMelbourneVICAustralia
- Monash Lung and Sleep, Monash HealthMonash Medical CentreMelbourneVICAustralia
| | - Steven Phu
- Department of Medicine—Western Health, Melbourne Medical SchoolThe University of MelbourneSt AlbansVICAustralia
- Australian Institute for Musculoskeletal Science (AIMSS)University of Melbourne and Western HealthSt AlbansVICAustralia
| | - Andrea A. Morita
- Department of PhysiotherapyLondrina State UniversityLondrinaParanáBrazil
- Centre of Research and Post‐Graduation in Health Sciences (CEPPOS)Londrina State UniversityLondrinaParanáBrazil
| | - Gustavo Duque
- Department of Medicine—Western Health, Melbourne Medical SchoolThe University of MelbourneSt AlbansVICAustralia
- Australian Institute for Musculoskeletal Science (AIMSS)University of Melbourne and Western HealthSt AlbansVICAustralia
| | - Vanessa S. Probst
- Department of PhysiotherapyLondrina State UniversityLondrinaParanáBrazil
- Centre of Research and Post‐Graduation in Health Sciences (CEPPOS)Londrina State UniversityLondrinaParanáBrazil
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Demircioğlu H, Cihan FG, Kutlu R, Yosunkaya Ş, Zamani A. Frequency of sarcopenia and associated outcomes in patients with chronic obstructive pulmonary disease. Turk J Med Sci 2020; 50:1270-1279. [PMID: 32421282 PMCID: PMC7491298 DOI: 10.3906/sag-1909-36] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 05/16/2020] [Indexed: 11/29/2022] Open
Abstract
Background/aim We aimed to evaluate the prevalence of sarcopenia and associated outcomes in patients with chronic obstructive pulmonary disease (COPD). Materials and methods This cross-sectional study was performed on 219 patients aged 50 years and over who were diagnosed with chronic obstructive pulmonary disease (COPD) according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. The study included 196 (89.5%) male and 23 (10.5%) female patients. The mean age of the patients was 66.9 ± 10.1 years. To diagnose sarcopenia, muscle function was determined by a gait speed test. Muscle strength was assessed with a hand dynamometer and muscle mass was measured with a bioelectrical impedance analysis device. Pulmonary function tests and six-min walking tests were also performed. The modified Medical Research Council (mMRC) dyspnoea scale was used to evaluate all the participants. Our sample consisted of sarcopenic patients at different stages (17 presarcopenic patients (7.8%), 32 patients with sarcopenia (14.6%), 65 patients with severe sarcopenia (29.7%), and 105 nonsarcopenic patients (47.9%). Results Sarcopenia was significantly associated with age, BODE (body mass index (BMI), airflow obstruction, dyspnoea, and exercise capacity) index, GOLD spirometric classification, mMRC dyspnoea scale score, BMI, and educational status. Sarcopenia in COPD patients was firmly related to the severity of the disease and its prognosis. The prevalence of sarcopenia increased in severe and very severe COPD cases. The dyspnoea score was higher, and exercise capacities were lower in sarcopenic patients. Conclusions Sarcopenia in COPD patients was closely related to the severity of COPD and a negative prognosis. The frequency of sarcopenia increased in severe and very severe COPD cases. Dyspnoea scores were higher and exercise capacities were lower in patients with sarcopenia. In patients with COPD, a diagnosis of sarcopenia should be considered, and preventive measures should be taken before irreversible changes develop.
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Affiliation(s)
- Havva Demircioğlu
- Department of Family Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Fatma Gökşin Cihan
- Department of Family Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Ruhuşen Kutlu
- Department of Family Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Şebnem Yosunkaya
- Department of Chest Diseases, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Adil Zamani
- Department of Chest Diseases, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
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Chua JR, Tee ML. Association of sarcopenia with osteoporosis in patients with chronic obstructive pulmonary disease. Osteoporos Sarcopenia 2020; 6:129-132. [PMID: 33102806 PMCID: PMC7573500 DOI: 10.1016/j.afos.2020.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/07/2020] [Accepted: 07/28/2020] [Indexed: 01/07/2023] Open
Abstract
Objectives Systemic consequence of Chronic Obstructive Pulmonary Disease (COPD) is associated with progressive loss of muscle mass and function. Preliminary studies showed presence of sarcopenia in COPD leads to reduced pulmonary function and quality of life; studies on whether this condition results in consequent loss of bone mineral density (BMD) is still inconsistent. This study aims to examine the association of sarcopenia in COPD with osteoporosis. Methods This is a post-hoc analysis of a study on forty-one (n = 41) participants with COPD seen in a tertiary public hospital in Manila, Philippines who underwent pulmonary function test and dual-energy x-ray absorptiometry. Sarcopenia was defined using a Philippine-based criteria of low fat free mass index (FFMI) and low muscle strength - hand grip strength, and osteoporosis using World Health Organization T-score diagnostic criteria. Results The prevalence of osteoporosis among COPD is 44%, and 63% in COPD with sarcopenia. There was no statistical difference seen in pulmonary function variables between COPD with and without osteoporosis. Significant positive correlations were observed between Forced Expiratory Volume in 1 s, FFMI, and appendicular lean muscle with total body BMD. Sarcopenia in COPD was associated with significantly increased risk for osteoporosis. Conclusions High prevalence rate of osteoporosis, and even higher among sarcopenic Filipino COPD patients should be further studied. The findings also suggest that sarcopenia in COPD is associated with increased risk of osteoporosis, and osteoporosis alone does not seem to affect lung function.
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Affiliation(s)
- Jamie R. Chua
- Division of Pulmonary Medicine, Department of Medicine, Philippine General Hospital, University of the Philippines, Manila, Philippines
| | - Michael L. Tee
- Department of Physiology and Division of Rheumatology, Department of Medicine, College of Medicine, University of the Philippines, Manila, Philippines
- Corresponding author.
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Rondanelli M, Faliva MA, Peroni G, Infantino V, Gasparri C, Iannello G, Perna S, Alalwan TA, Al-Thawadi S, Corsico AG. Food Pyramid for Subjects with Chronic Obstructive Pulmonary Diseases. Int J Chron Obstruct Pulmon Dis 2020; 15:1435-1448. [PMID: 32606652 PMCID: PMC7310971 DOI: 10.2147/copd.s240561] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 04/20/2020] [Indexed: 02/02/2023] Open
Abstract
Nutritional problems are an important part of rehabilitation for chronic obstructive pulmonary disease (COPD) patients. COPD patients often present with malnutrition, sarcopenia, and osteoporosis with possible onset of cachexia, with an inadequate dietary intake and a poor quality of life. Moreover, diet plays a pivotal role in patients with COPD through three mechanisms: regulation of carbon dioxide produced/oxygen consumed, inflammation, and oxidative stress. A narrative review based on 99 eligible studies was performed to evaluate current evidence regarding optimum diet therapy for the management of COPD, and then a food pyramid was built accordingly. The food pyramid proposal will serve to guide energy and dietary intake in order to prevent and treat nutritionally related COPD complications and to manage progression and COPD-related symptoms. The nutrition pyramid described in our narrative review is hypothetical, even in light of several limitations of the present review; the main limitation is the fact that to date there are no randomized controlled trials in the literature clearly showing that improved nutrition, via the regulation of carbon dioxide produced/oxygen consumed, inflammation and oxidative stress, improves symptoms and/or progression of COPD. Even if this nutritional pyramid is hypothetical, we hope that it can serve the valuable purpose of helping researchers focus on the often-ignored possible connections between body composition, nutrition, and COPD.
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Affiliation(s)
- Mariangela Rondanelli
- IRCCS Mondino Foundation, Pavia 27100, Italy.,Department of Public Health, Experimental and Forensic Medicine, Unit of Human and Clinical Nutrition, University of Pavia, Pavia 27100, Italy
| | - Milena Anna Faliva
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona "Istituto Santa Margherita", University of Pavia, Pavia 27100, Italy
| | - Gabriella Peroni
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona "Istituto Santa Margherita", University of Pavia, Pavia 27100, Italy
| | - Vittoria Infantino
- Department of Public Health, Experimental and Forensic Medicine, Unit of Human and Clinical Nutrition, University of Pavia, Pavia 27100, Italy
| | - Clara Gasparri
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona "Istituto Santa Margherita", University of Pavia, Pavia 27100, Italy
| | - Giancarlo Iannello
- General Management, Azienda di Servizi alla Persona "Istituto Santa Margherita", Pavia 27100, Italy
| | - Simone Perna
- Department of Biology, College of Science, University of Bahrain, Sakhir 32038, Bahrain
| | | | - Salwa Al-Thawadi
- Department of Biology, College of Science, University of Bahrain, Sakhir 32038, Bahrain
| | - Angelo Guido Corsico
- Center for Diagnosis of Inherited Alpha 1-Antitrypsin Deficiency, Department of Internal Medicine and Therapeutics, University of Pavia, Pavia 27100, Italy.,Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia 27100, Italy
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Sepúlveda-Loyola W, de Castro LA, Matsumoto AK, Camillo CA, Barbosa DS, Galvan CCR, Probst VS. NOVEL antioxidant and oxidant biomarkers related to sarcopenia in COPD. Heart Lung 2020; 50:184-191. [PMID: 32546379 DOI: 10.1016/j.hrtlng.2020.06.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 05/15/2020] [Accepted: 06/01/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND The relation between oxidative stress (OS) and sarcopenia in COPD remains unknown. OBJECTIVE To analyze OS levels and its association with sarcopenia in COPD. METHODS Thirty-nine individuals with COPD (69±7years; 41%female) and thirty-five for the control group (69±7years; 43%female) were included. Advanced oxidation protein products (AOPP), paraoxonase-1 (PON1), superoxide dismutase activity (SOD), catalase dismutase activity (CAT), sulfhydryl group (SH), nitric oxide metabolites (NOX), total radical trapping antioxidant parameter (TRAP) were analysed. OS markers were correlated with handgrip and quadriceps strength, gait speed, skeletal muscle mass index, fat-free mass index, maximum inspiratory and expiratory pressure. European criteria were used to identify sarcopenia. RESULTS In COPD, antioxidant capacity was correlated with muscle mass and strength (r from 0.5 to 0.64) P<0.05 for all. TRAP≤ 850 μM/trolox and AOPP≤65 μM/l were associated with sarcopenia (OR:8.3; 95% CI: 1.4-49.6 and OR:14; 95%CI: 2.2-87.1, respectively; P<0.05 for both). CONCLUSION OS is associated with sarcopenia in COPD.
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Affiliation(s)
- Walter Sepúlveda-Loyola
- Program of Masters and Doctoral degree in Rehabilitation Sciences, Londrina State University (UEL) and University North of Paraná (UNOPAR), Londrina, Brazil
| | - Larissa Araújo de Castro
- Program of Masters and Doctoral degree in Rehabilitation Sciences, Londrina State University (UEL) and University North of Paraná (UNOPAR), Londrina, Brazil
| | | | - Carlos Augusto Camillo
- Program of Masters and Doctoral degree in Rehabilitation Sciences, Londrina State University (UEL) and University North of Paraná (UNOPAR), Londrina, Brazil
| | | | - Carrie Chueiri Ramos Galvan
- Program of Masters and Doctoral degree in Rehabilitation Sciences, Londrina State University (UEL) and University North of Paraná (UNOPAR), Londrina, Brazil
| | - Vanessa Suziane Probst
- Program of Masters and Doctoral degree in Rehabilitation Sciences, Londrina State University (UEL) and University North of Paraná (UNOPAR), Londrina, Brazil.
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41
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Attaway AH, Welch N, Hatipoğlu U, Zein JG, Dasarathy S. Muscle loss contributes to higher morbidity and mortality in COPD: An analysis of national trends. Respirology 2020; 26:62-71. [PMID: 32542761 DOI: 10.1111/resp.13877] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 05/06/2020] [Accepted: 05/18/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND OBJECTIVE COPD is the third most common cause of death worldwide and fourth most common in the United States. In hospitalized patients with COPD, mortality, morbidity and healthcare resource utilization are high. Skeletal muscle loss is frequent in patients with COPD. However, the impact of muscle loss on adverse outcomes has not been systematically evaluated. We tested the hypothesis that patients hospitalized for COPD exacerbation with, compared to those without, a secondary diagnosis of muscle loss phenotype (all ICD-9 codes associated with muscle loss including cachexia) will have higher mortality and cost of care. METHODS The NIS database of hospitalized patients in 2011 (1 January-31 December) in the United States was used. The impact of a muscle loss phenotype on in-hospital mortality, LOS and cost of care for each of the 174 808 hospitalizations for COPD exacerbations was analysed. RESULTS Of the subjects admitted for a COPD exacerbation, 12 977 (7.4%) had a secondary diagnosis of muscle loss phenotype. A diagnosis of muscle loss phenotype was associated with significantly higher in-hospital mortality (14.6% vs 5.7%, P < 0.001), LOS (13.3 + 17.1 vs 5.7 + 7.6, P < 0.001) and median hospital charge per patient ($13 947 vs $6610, P < 0.001). Multivariate regression analysis showed that muscle loss phenotype increased mortality by 111% (95% CI: 2.0-2.2, P < 0.001), LOS by 68.4% (P < 0.001) and the direct cost of care by 83.7% (P < 0.001) compared to those without muscle loss. CONCLUSION In-hospital mortality, LOS and healthcare costs are higher in patients with COPD exacerbations and a muscle loss phenotype.
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Affiliation(s)
- Amy H Attaway
- Department of Pulmonology, Cleveland Clinic, Cleveland, OH, USA.,Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, OH, USA
| | - Nicole Welch
- Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, OH, USA.,Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, USA
| | - Umur Hatipoğlu
- Department of Pulmonology, Cleveland Clinic, Cleveland, OH, USA
| | - Joe G Zein
- Department of Pulmonology, Cleveland Clinic, Cleveland, OH, USA.,Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, OH, USA
| | - Srinivasan Dasarathy
- Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, OH, USA.,Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, USA
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Adas-Okuma MG, Maeda SS, Gazzotti MR, Roco CM, Pradella CO, Nascimento OA, Porto EF, Vieira JGH, Jardim JR, Lazaretti-Castro M. COPD as an independent risk factor for osteoporosis and fractures. Osteoporos Int 2020; 31:687-697. [PMID: 31811311 DOI: 10.1007/s00198-019-05235-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 11/14/2019] [Indexed: 02/07/2023]
Abstract
UNLABELLED Fractures are common in individuals with COPD and occur at higher bone mass values than expected. COPD appears to be an important risk factor for bone fragility. INTRODUCTION Patients with chronic obstructive pulmonary disease (COPD) have an increased risk of osteoporosis and fractures, but screening and prophylactic measures to prevent both disorders are often neglected in this population. This case-control study assessed the prevalence of osteopenia, osteoporosis, and fractures in patients with COPD, and identified potential risk factors for fractures in this population. METHODS Overall, 91 patients with COPD (COPD group; COPDG) and 81 age- and sex-matched controls (control group; CG) were assessed with bone mineral density (BMD), thoracic/lumbar spine radiographs, and serum PTH and 25-hydroxyvitamin D (25[OH]D) levels. The occurrence of prior fractures was retrieved from clinical history. RESULTS The prevalence of total fractures in the COPDG was 57.1% (odds of fracture 4.7 times greater compared with the CG), and the femoral neck T-score emerged as the best predictor of fractures. Compared with the CG, the COPDG had lower spine and femoral BMD (p ≤ 0.01) and 25(OH)D levels (p = 0.01) and 2.6 times greater odds of osteoporosis. Among men, vertebral fractures were more prevalent in the COPDG versus CG (25.9% vs. 6.5%, respectively, p = 0.01). The odds of fracture increased with femoral neck T-scores ≤ - 2.7 in the CG and ≤ - 0.6 in the COPDG. CONCLUSION These results add robust evidence to an increased odds of osteoporosis and fractures in COPD. Fractures in the COPDG occurred at higher BMD values than expected, suggesting that COPD may be an independent marker of fracture risk, reinforcing a need for regular osteoporosis screening with BMD measurement and prophylaxis of fractures in patients with this disorder.
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Affiliation(s)
- M G Adas-Okuma
- Discipline of Endocrinology, Escola Paulista de Medicina (UNIFESP) Universidade Federal de São Pulo, Federal University of São Paulo, Rua Botucatu, 806, Vila Clementino, São Paulo, SP, Brazil.
| | - S S Maeda
- Discipline of Endocrinology, Escola Paulista de Medicina (UNIFESP) Universidade Federal de São Pulo, Federal University of São Paulo, Rua Botucatu, 806, Vila Clementino, São Paulo, SP, Brazil
| | - M R Gazzotti
- Discipline of Pulmonology, Escola Paulista de Medicina (UNIFESP), Rua Botucatu, 989 Vila Clementino, São Paulo, SP, Brazil
| | - C M Roco
- Discipline of Pulmonology, Escola Paulista de Medicina (UNIFESP), Rua Botucatu, 989 Vila Clementino, São Paulo, SP, Brazil
| | - C O Pradella
- Discipline of Pulmonology, Escola Paulista de Medicina (UNIFESP), Rua Botucatu, 989 Vila Clementino, São Paulo, SP, Brazil
| | - O A Nascimento
- Discipline of Pulmonology, Escola Paulista de Medicina (UNIFESP), Rua Botucatu, 989 Vila Clementino, São Paulo, SP, Brazil
| | - E F Porto
- Discipline of Pulmonology, Escola Paulista de Medicina (UNIFESP), Rua Botucatu, 989 Vila Clementino, São Paulo, SP, Brazil
| | - J G H Vieira
- Discipline of Endocrinology, Escola Paulista de Medicina (UNIFESP) Universidade Federal de São Pulo, Federal University of São Paulo, Rua Botucatu, 806, Vila Clementino, São Paulo, SP, Brazil
| | - J R Jardim
- Discipline of Pulmonology, Escola Paulista de Medicina (UNIFESP), Rua Botucatu, 989 Vila Clementino, São Paulo, SP, Brazil
| | - M Lazaretti-Castro
- Discipline of Endocrinology, Escola Paulista de Medicina (UNIFESP) Universidade Federal de São Pulo, Federal University of São Paulo, Rua Botucatu, 806, Vila Clementino, São Paulo, SP, Brazil
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Landi F, Salini S, Zazzara MB, Martone AM, Fabrizi S, Bianchi M, Tosato M, Picca A, Calvani R, Marzetti E. Relationship between pulmonary function and physical performance among community-living people: results from Look-up 7+ study. J Cachexia Sarcopenia Muscle 2020; 11:38-45. [PMID: 31800168 PMCID: PMC7015242 DOI: 10.1002/jcsm.12485] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 06/28/2019] [Accepted: 07/22/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND While respiratory muscle strength is recognized to decline with aging process, the relationship between sarcopenia and pulmonary function remains to be studied. The present study was undertaken to provide a better insight into the comprehension of the relationship between pulmonary function and muscle function (strength and physical performance) using an unselected sample of subjects assessed during the Longevity Check-up 7+ project. METHODS Look-up 7+ is an ongoing cross-sectional survey started in June 2015 and conducted in unconventional settings (i.e. exhibitions, malls, and health promotion campaigns) across Italy. Candidate participants are eligible for enrolment if they are at least 18 years of age and provide written informed consent. Muscle strength was assessed by handgrip strength test, and physical performance was evaluated by chair stand test. Spirometer analysis was performed using the AirSmart system, and the largest forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and peak expiratory flow (PEF) values were collected. RESULTS The mean age of 925 subjects participating in the Longevity check-7+ surveys and receiving the spirometer evaluation was 55.6 years (range from 18 to 98 years), and 501 (54%) were women. Overall, both in male and female participants, FVC, FEV1 and PEF positively correlated with handgrip strength and chair stand tests. The receiver operator characteristic curve analysis revealed that the areas under the curves for FVC, FEV1, and PEF were 0.79, 0.80 and 0.80, respectively. CONCLUSIONS The results clearly show that pulmonary function was positively associated with handgrip strength and chair stand tests. Based on this observation, muscle strength, physical performance, and pulmonary function should be recommended as the method of choice for the early detection of individuals at risk of probable sarcopenia and at the same time to better characterized the severity of sarcopenia status.
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Affiliation(s)
- Francesco Landi
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Sara Salini
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Maria Beatrice Zazzara
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Anna Maria Martone
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Sofia Fabrizi
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Mariangela Bianchi
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Matteo Tosato
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Anna Picca
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Riccardo Calvani
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Emanuele Marzetti
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
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Nunes MF, Hervé BB, Lukrafka JL, Monteiro MB. Handgrip strength and its relation to isokinetic dynamometry in COPD. FISIOTERAPIA EM MOVIMENTO 2020. [DOI: 10.1590/1980-5918.033.ao56] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction: Muscle dysfunction is one of the major changes found in chronic obstructive pulmonary disease (COPD) and associated with loss of functionality, morbidity and mortality. Objective: correlate two strength assessment methods: manual dynamometry for handgrip strength and isokinetic dynamometry for quadriceps strength in patients with COPD, and assess the body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE), quality of life and muscle strength. Method: twenty-five patients with moderate to very severe COPD were evaluated by pulmonary function parameters, anthropometric variables, functional capacity, via the six-minute walk test, dyspnea, applying the modified Medical Research Council (mMRC) scale, BODE, quality of life, using the Saint George's Respiratory Questionnaire (SGRQ), handgrip strength with manual dynamometer and quadriceps force using an isokinetic dynamometer. Muscle strength was assessed with a manual portable dynamometer and isokinetic dynamometer. For statistical analysis, ANOVA with Bonferroni’s post-test, the chi-squared test and Pearson's correlation coefficient were used. Results: There was a strong correlation between the strength measurements and the two instruments (torque and quadriceps extension power with right handgrip strength: r = 0.74; p <0.001). The patients classified as very severe exhibited worse performance in the strength tests when compared to the moderate group, albeit with no statistically significant difference. Conclusion: In muscle strength measurements, a strong correlation was detected between the isokinetic dynamometer for quadriceps and the manual dynamometer for handgrip strength. These findings indicate that, in clinical practice, the manual dynamometer for handgrip strength could be used to assess peripheral muscle strength in patients with COPD.
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Ohara DG, Pegorari MS, Oliveira Dos Santos NL, de Fátima Ribeiro Silva C, Oliveira MSR, Matos AP, Jamami M. Cross-Sectional Study on the Association between Pulmonary Function and Sarcopenia in Brazilian Community-Dwelling Elderly from the Amazon Region. J Nutr Health Aging 2020; 24:181-187. [PMID: 32003408 DOI: 10.1007/s12603-019-1290-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To compare the obtained and expected values of pulmonary function variables between sarcopenic and non-sarcopenic elderly; verify the association between the pulmonary function and the indicators and diagnosis of sarcopenia; and establish cut-off points for pulmonary function variables to predict sarcopenia. DESIGN Cross-sectional study. LOCATION Macapá, Brazil. PARTICIPANTS community-dwelling elderly ≥ 60 years old (n=383), both sexes. MEASURES Were evaluated according to variables of pulmonary function (spirometry) and sarcopenia, according to the EWGSOP consensus. The association between pulmonary function and sarcopenia was performed using logistic regression and cut-off points established from the ROC Curve. RESULTS The prevalence of sarcopenia was 12.53% (n = 48). Sarcopenic individuals had significantly lower mean values for FVC, FEV1, FEF25-75% and PEF than non-sarcopenic. After adjustment, spirometric variables were inversely associated with sarcopenia (the increase by one unit of liter in FVC, FEV1 and FEF25-75% decreased the probability of sarcopenia by 59%, 67% and 39%, respectively), and the majority of these variables with the muscular strength indicator. Cut-off points, for elderly men and women, were discriminant criteria for the presence of sarcopenia: FVC (≤2.52 L and ≤1.82 L), FEV1 (≤2.1 L and ≤1.39 L), PEF (≤3.45 L/s and ≤2.93 L/s) and FEF5-75% (≤1.97 L/s and ≤1.74 L/s). CONCLUSIONS There was loss of pulmonary function in sarcopenic elderly patients and an inverse association with the diagnosis of sarcopenia and its indicators. Cut-off points of pulmonary function variables can be used as a useful tool to discriminate sarcopenia.
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Affiliation(s)
- D G Ohara
- Maycon Sousa Pegorari, Federal University of Amapá, Department of biological and health sciences, Physical Therapy Course. Address: Road Juscelino Kubitschek, Km - 02, Jardim Marco Zero, Macapá - AP, CEP 68903-419 - Phone number: (+55 96) 4009-2944 E-mail:
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46
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Zhi J, Shan Q, Liang L, Liu H, Huang H. Low skeletal muscle area as a prognostic marker for chronic obstructive pulmonary disease in elderly patients admitted to ICU. Sci Rep 2019; 9:19117. [PMID: 31836824 PMCID: PMC6911085 DOI: 10.1038/s41598-019-55737-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 12/02/2019] [Indexed: 12/26/2022] Open
Abstract
Low L3 skeletal muscle area (SMA), which is assessed on computed tomography (CT) images, has been reported to indicate poor clinical outcomes of patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). The dorsal muscle group area at the T12 vertebral level (T12DMA) was used as an alternative to L3 SMA. This study aimed to investigate whether T12DMA could be used as a predictor of in-hospital mortality and long-term survival in elderly patients with COPD admitted to the intensive care unit (ICU). This single-center retrospective case-control study was performed by analyzing the clinical information and measuring T12DMA on chest CT images of elderly patients with COPD admitted to the ICU between May 2013 and May 2018. This study included 136 patients. The multivariate logistic regression analysis showed that T12DMA, neutrophil-lymphocyte ratio, invasive mechanical ventilation, and systemic steroid therapy were independent risk factors for predicting the hospital mortality. The median survival was significantly higher in the high-T12DMA group (214 days) than in the low-T12DMA group (32 days).
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Affiliation(s)
- Jiehua Zhi
- Department of Gastroenterology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Qing Shan
- Department of Gerontology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Lanyu Liang
- Department of Gerontology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China.
| | - Han Liu
- Department of Gerontology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Hua Huang
- Department of Radiology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
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47
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Chua JR, Albay AB, Tee ML. Body Composition of Filipino Chronic Obstructive Pulmonary Disease (COPD) Patients in Relation to Their Lung Function, Exercise Capacity and Quality of Life. Int J Chron Obstruct Pulmon Dis 2019; 14:2759-2765. [PMID: 31819408 PMCID: PMC6897050 DOI: 10.2147/copd.s222809] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 11/01/2019] [Indexed: 12/20/2022] Open
Abstract
Background and objectives The loss of muscle or fat free mass (FFM) as a result of systemic inflammation and poor nutrition in Chronic Obstructive Pulmonary Disease (COPD), is recognized as an important factor that influences symptoms and disease-related outcomes. To date, there are no data on body composition among Filipino COPD patients and how it impacts COPD disease severity. This paper examined the relationship of Fat Free Mass Index (FFMI = FFM/height) and sarcopenia with COPD disease severity variables. Methods This was a cross-sectional analytic study comparing low and normal FFMI, sarcopenic and nonsarcopenic COPD patients, in terms of lung function, exercise capacity, and quality of life score. Filipino COPD patients older than 40 years were included. Patients performed six minute walking distance (6MWD), handgrip strength (HGS), and quality of life status evaluation using Filipino version of COPD Assessment Test (CAT). Body composition was measured using bioelectrical impedance analysis (BIA). Results A total of 41 patients were included. The mean age was 69.22 years. The prevalence of being underweight and having sarcopenia was 32% and 46%, respectively. Point biserial correlation showed that COPD patients with low FFMI had a statistically significant reduction in peak inspiratory flow (r= −0.5791, P value 0.0002), peak expiratory flow (r= −0.4475, P value 0.0055), and handgrip strength (r= −0.4560, P value 0.0027); and lower CAT score (r= −0.3422, P value 0.0285). Similar findings were observed among sarcopenic COPD patients. Conclusion The prevalence of being underweight and having sarcopenia was high. Low FFMI results in reduction of lung function and upper limb muscle strength among Filipino COPD patients.
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Affiliation(s)
- Jamie R Chua
- Division of Pulmonary Medicine, Department of Medicine, Philippine General Hospital, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Albert B Albay
- Division of Pulmonary Medicine, Department of Medicine, Philippine General Hospital, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Michael L Tee
- Associate Professor, Department of Physiology and Division of Rheumatology, Department of Medicine, College of Medicine, University of the Philippines Manila, Manila, Philippines
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48
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Benz E, Trajanoska K, Lahousse L, Schoufour JD, Terzikhan N, De Roos E, de Jonge GB, Williams R, Franco OH, Brusselle G, Rivadeneira F. Sarcopenia in COPD: a systematic review and meta-analysis. Eur Respir Rev 2019; 28:28/154/190049. [PMID: 31722892 PMCID: PMC9488535 DOI: 10.1183/16000617.0049-2019] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 08/05/2019] [Indexed: 12/28/2022] Open
Abstract
COPD is associated with a progressive loss of muscle mass and function. However, there is an unmet need to define and standardise methods to estimate the prevalence of sarcopenia in COPD patients. We performed a systematic review and meta-analysis of the prevalence of this extrapulmonary manifestation in COPD patients. We searched Embase, Medline (Ovid), CINAHL (EBSCO), Web of Science, Scopus and Google Scholar for studies published up to January 17, 2019, assessing sarcopenia in COPD patients based on low muscle mass and decreased muscle function. Interventional studies, in vitro experiments, protocols or reviews and meta-analyses were excluded. We estimated heterogeneity (I2) and assessed significance (Q) using a Chi-squared test for estimates obtained from random-effects models. 4465 articles were initially identified. After removing the duplicates and applying the selection criteria, we reviewed 62 full-text articles. Finally, 10 articles (n=2565 COPD patients) were included in this systematic review and meta-analyses. Overall, the prevalence of sarcopenia in patients with COPD was 21.6% (95% CI 14.6–30.9%, I2=94%), ranging from 8% in population-based to 21% in clinic-based studies, and 63% in COPD patients residing in nursing homes. Sarcopenia is frequently observed in COPD patients, with varying prevalence across population settings. Sarcopenia in COPD should be assessed using standardised tests and cut-off points from sarcopenia consensus criteria for clinical practice and international comparisons. We confirmed a high prevalence of sarcopenia in COPD patients, with varying prevalence across population settings. We recommend adhering to the sarcopenia consensus criteria to systematically evaluate the muscle health of COPD patients.http://bit.ly/2KA6weh
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Affiliation(s)
- Elizabeth Benz
- Dept of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Dept of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Both authors contributed equally
| | - Katerina Trajanoska
- Dept of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Dept of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Both authors contributed equally
| | - Lies Lahousse
- Dept of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Dept of Bioanalysis, FFW, Ghent University, Ghent, Belgium
| | - Josje D Schoufour
- Dept of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Dept of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Natalie Terzikhan
- Dept of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Dept of Respiratory Medicine, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Emmely De Roos
- Dept of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Dept of Respiratory Medicine, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Gerdien B de Jonge
- Medical Library, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ross Williams
- Dept of Medical Informatics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Oscar H Franco
- Dept of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Guy Brusselle
- Dept of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands .,Dept of Respiratory Medicine, Ghent University Hospital, Ghent University, Ghent, Belgium.,Dept of Respiratory Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Fernando Rivadeneira
- Dept of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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49
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Atmis V, Yalcin A, Silay K, Ulutas S, Bahsi R, Turgut T, Mut Sürmeli D, Selvi Öztorun H, Yaman S, Çoşarderelioğlu Ç, Aras S, Varli M. The relationship between all-cause mortality sarcopenia and sarcopenic obesity among hospitalized older people. Aging Clin Exp Res 2019; 31:1563-1572. [PMID: 31350700 DOI: 10.1007/s40520-019-01277-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 07/15/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIM Sarcopenia and sarcopenic obesity (SO) are associated with adverse health outcomes in older people. Data on sarcopenia- and SO-related mortality are insufficient for hospitalized older people. The aim of this study was to evaluate the relationship between sarcopenia, SO and mortality among hospitalized older people. METHODS Two-centered prospective observational study was conducted among 350 hospitalized older people in geriatric units of two university hospitals. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People. Obesity was defined according to fat mass percentage. Medical history, cognitive status, nutritional status and functionality and laboratory tests were assessed. All-cause mortality rate was recorded at 2 years. RESULTS The prevalence of SO was 21.1%. The prevalence of sarcopenia was 11.4%. Both sarcopenia (log rank p < 0.001) and SO (log rank p < 0.001) were associated with all-cause mortality at 2 years. There was no difference between sarcopenia and SO for mortality. SO (HR 5.23, p < 0.001), sarcopenia (HR 9.26, p < 0.001), male gender (HR 2.25, p = 0.035), Lawton IADL (HR 0.77, p = 0.02), heart failure (HR 3.25, p = 0.02) and chronic obstructive lung disease (HR 5.16, p = 0.01) were independently related to all-cause mortality. DISCUSSION AND CONCLUSIONS Both sarcopenia and SO showed an independent relationship for 2-year all-cause mortality after hospital discharge. These results suggest that preventive and treatment options should be taken to decrease mortality associated with these conditions among hospitalized older people.
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Affiliation(s)
- Volkan Atmis
- Department of Geriatric Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Ahmet Yalcin
- Department of Geriatric Medicine, Ataturk's Training and Research Hospital, Ankara, Turkey.
- , Gazi Osman Paşa-Ankara, Turkey.
| | - Kamile Silay
- Department of Geriatric Medicine, Yildirim Bayazit University School of Medicine, Ankara, Turkey
| | - Sumeyye Ulutas
- Department of Geriatric Medicine, Ataturk's Training and Research Hospital, Ankara, Turkey
| | - Remzi Bahsi
- Department of Geriatric Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Tugba Turgut
- Department of Geriatric Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Deniz Mut Sürmeli
- Department of Geriatric Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Hande Selvi Öztorun
- Department of Geriatric Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Samet Yaman
- Department of Geriatric Medicine, Ataturk's Training and Research Hospital, Ankara, Turkey
| | | | - Sevgi Aras
- Department of Geriatric Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Murat Varli
- Department of Geriatric Medicine, Ankara University School of Medicine, Ankara, Turkey
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50
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Mansour KMK, Goulart CDL, Carvalho-Junior LCSD, Trimer R, Borghi-Silva A, Silva ALGD. Pulmonary function and functional capacity cut-off point to establish sarcopenia and dynapenia in patients with COPD. ACTA ACUST UNITED AC 2019; 45:e20180252. [PMID: 31644702 PMCID: PMC8653115 DOI: 10.1590/1806-3713/e20180252] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 02/26/2019] [Indexed: 12/02/2022]
Abstract
Objective To establish a cut-off point for clinical and functional variables to determinate sarcopenia and dynapenia in COPD patients, and to analyze the impact of skeletal muscle dysfunction (SMD) on these variables. Methods Cross-sectional study, screened COPD patients for sarcopenia or dynapenia through low muscle mass and hand grip strength (HGS). Clinical variables: pulmonary function, respiratory muscle strength and functional capacity (FC). The precision of the variables in determining points of predictive cut-off for sarcopenia or dynapenia were performed using the Receiver Operating Characteristic curve and two-way analysis of variance. Results 20 COPD patients stratified for sarcopenia (n = 11) and dynapenia (n = 07). Sarcopenia group presented lower lean mass and lower maximal inspiratory pressure (MIP), decreased HGS, reduced FC (p<0.050). Dynapenia group presented reduced MIP, lower HGS and walked a shorter distance at Incremental shuttle walk test (ISWT) (p<0.050). We found cut-off points of forced expiratory volume in one second (FEV1), MIP and maximal expiratory pressure (MEP) and ISWT. It is possible to identify sarcopenia or dynapenia in these patients. We found the coexistence of the conditions (SMD effect) in COPD – reduction in the distance in the ISWT (p = 0.002) and %ISWT (p = 0.017). Conclusion In moderate to very severe COPD patients the sarcopenia could be predicted by FEV1 (%predicted) < 52, MIP < 73 cmH2O, MEP < 126 cmH2O and distance traveled of < 295 m in ISWT. Whereas dynapenia could be predicted by FEV1 < 40%, MIP < 71 cmH2O, MEP < 110 cmH2O and distance of < 230 m traveled in ISWT.
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Affiliation(s)
| | - Cássia da Luz Goulart
- Laboratório de Fisioterapia Cardiopulmonar, Universidade Federal de São Carlos, São Carlos (SP) Brasil
| | | | - Renata Trimer
- Departamento de Educação Física e Saúde, Universidade de Santa Cruz do Sul, Santa Cruz do Sul (RS) Brasil
| | - Audrey Borghi-Silva
- Laboratório de Fisioterapia Cardiopulmonar, Universidade Federal de São Carlos, São Carlos (SP) Brasil
| | - Andréa Lúcia Gonçalves da Silva
- Departamento de Educação Física e Saúde, Universidade de Santa Cruz do Sul, Santa Cruz do Sul (RS) Brasil.,Programa de Reabilitação Cardiorrespiratória, Hospital Santa Cruz, Santa Cruz do Sul (RS) Brasil
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