Nanca Cebron Lipovec1, Annemie M W J Schols2, Bram van den Borst2, Rosanne J H C G Beijers2, Tatjana Kosten3, Daniel Omersa4, Mitja Lainscak5. 1. University Clinic of Pulmonary and Allergic Diseases Golnik, Golnik, Slovenia; NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands. 2. NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands. 3. University Clinic of Pulmonary and Allergic Diseases Golnik, Golnik, Slovenia. 4. National Institute of Public Health, Ljubljana, Slovenia. 5. Department of Cardiology and Department of Research and Education, General Hospital, Celje, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia. Electronic address: mitja.lainscak@guest.arnes.si.
Abstract
OBJECTIVES: Sarcopenia is common in chronic obstructive pulmonary disease (COPD) and may contribute to increased cardiometabolic risk. Interventions to reduce cardiometabolic risk in advanced COPD have been scarcely studied. We have investigated the cardiometabolic effect of a short-term high-intensity rehabilitation program in sarcopenic and nonsarcopenic patients with advanced COPD. DESIGN: Prospective observational study. SETTING: Inpatient 4-week short-term high-intensity pulmonary rehabilitation program at the University Clinic Golnik, Slovenia. PARTICIPANTS: 112 stable COPD patients (66 ± 8 years, 85% GOLD III/IV, 66% men). MEASUREMENTS: Blood biomarkers were assessed at baseline and after rehabilitation. Sarcopenia was assessed at baseline (skeletal muscle index <7.23 kg/m(2) for men and <5.67 kg/m(2) for women, as measured by whole-body dual energy X-ray absorptiometry. Insulin resistance (IR) was defined as homeostasis model assessment of insulin resistance (HOMA-IR) above 2.5. RESULTS: IR and sarcopenia were detected in 59% and 55% of patients, respectively. In contrast to sarcopenic patients, rehabilitation decreased HOMA-IR (2.8 to 1.9, P = .031), fat mass index (10.1 to 9.7 kg/m(2), P = .013), waist circumference (103 to 101 cm, P = .002), and low-density lipoprotein cholesterol (3.2 to 3.0 mmol/L, P = .034) in nonsarcopenic patients. A decrease in total cholesterol levels was observed in both groups. CONCLUSIONS: Sarcopenia affects the modification of cardiometabolic risk markers by short-term high-intensity pulmonary rehabilitation in advanced COPD patients.
OBJECTIVES:Sarcopenia is common in chronic obstructive pulmonary disease (COPD) and may contribute to increased cardiometabolic risk. Interventions to reduce cardiometabolic risk in advanced COPD have been scarcely studied. We have investigated the cardiometabolic effect of a short-term high-intensity rehabilitation program in sarcopenic and nonsarcopenic patients with advanced COPD. DESIGN: Prospective observational study. SETTING: Inpatient 4-week short-term high-intensity pulmonary rehabilitation program at the University Clinic Golnik, Slovenia. PARTICIPANTS: 112 stable COPD patients (66 ± 8 years, 85% GOLD III/IV, 66% men). MEASUREMENTS: Blood biomarkers were assessed at baseline and after rehabilitation. Sarcopenia was assessed at baseline (skeletal muscle index <7.23 kg/m(2) for men and <5.67 kg/m(2) for women, as measured by whole-body dual energy X-ray absorptiometry. Insulin resistance (IR) was defined as homeostasis model assessment of insulin resistance (HOMA-IR) above 2.5. RESULTS: IR and sarcopenia were detected in 59% and 55% of patients, respectively. In contrast to sarcopenic patients, rehabilitation decreased HOMA-IR (2.8 to 1.9, P = .031), fat mass index (10.1 to 9.7 kg/m(2), P = .013), waist circumference (103 to 101 cm, P = .002), and low-density lipoprotein cholesterol (3.2 to 3.0 mmol/L, P = .034) in nonsarcopenic patients. A decrease in total cholesterol levels was observed in both groups. CONCLUSIONS:Sarcopenia affects the modification of cardiometabolic risk markers by short-term high-intensity pulmonary rehabilitation in advanced COPD patients.
Authors: Valérie Coats; Jean-Pierre Després; Natalie Alméras; Mickaël Martin; Don D Sin; Rémi Rabasa-Lhoret; Éric Larose; Wan C Tan; Jean Bourbeau; François Maltais Journal: Int J Chron Obstruct Pulmon Dis Date: 2018-10-15
Authors: Anita E M Kneppers; Roy A M Haast; Ramon C J Langen; Lex B Verdijk; Pieter A Leermakers; Harry R Gosker; Luc J C van Loon; Mitja Lainscak; Annemie M W J Schols Journal: J Cachexia Sarcopenia Muscle Date: 2019-01-18 Impact factor: 12.910
Authors: P A Leermakers; A M W J Schols; A E M Kneppers; M C J M Kelders; C C de Theije; M Lainscak; H R Gosker Journal: Sci Rep Date: 2018-10-09 Impact factor: 4.379
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