BACKGROUND/ OBJECTIVES: None of the cutoff points for fat-free mass index (FFMI) were tested for the Brazilian population, and it is unknown whether the available ones are able to discriminate extrapulmonary disease manifestations. This cross-sectional study aims to develop and validate a cutoff point for FFM depletion based on Brazilian patients with chronic obstructive pulmonary disease (COPD) and to verify its association and of previously published cutoffs with extrapulmonary manifestations. SUBJECTS/ METHODS: A new cutoff point was obtained from the best FFMI value for discrimination of preserved exercise capacity in a sample of patients (n=57). The discriminative capacity was assessed in another sample (n=96). The new cutoff point and other previously published ones were tested to discriminate low exercise capacity, physical inactivity, sedentary lifestyle and low quality of life. A receiver operation characteristics curve with area under the curve (AUC) value was plotted and each cutoff points' discriminative capacity was calculated. Cox regression and Kaplan-Meier method assessed the association between the cutoff points and mortality. RESULTS: The new cutoff points for FFMI were 14.65 kg/m2 for women (AUC=0.744; sensitivity (Se)=0.88; specificity (Sp)=0.60) and 20.35 kg/m2 for men (AUC=0.565; Se=0.36; Sp=0.81). The new cutoffs were the best to discriminate poor exercise capacity assessed by walked distance in % predicted and quality of life. Only the new cutoff point was associated with mortality (HR=2.123; 95% CI: 1.03-4.33, P=0.039, log rank P=0.035). CONCLUSIONS: Only the new cutoff point was associated with all-cause mortality, and it had the highest discriminating capacity for exercise capacity and quality of life in Brazilian patients with COPD.
BACKGROUND/ OBJECTIVES: None of the cutoff points for fat-free mass index (FFMI) were tested for the Brazilian population, and it is unknown whether the available ones are able to discriminate extrapulmonary disease manifestations. This cross-sectional study aims to develop and validate a cutoff point for FFM depletion based on Brazilian patients with chronic obstructive pulmonary disease (COPD) and to verify its association and of previously published cutoffs with extrapulmonary manifestations. SUBJECTS/ METHODS: A new cutoff point was obtained from the best FFMI value for discrimination of preserved exercise capacity in a sample of patients (n=57). The discriminative capacity was assessed in another sample (n=96). The new cutoff point and other previously published ones were tested to discriminate low exercise capacity, physical inactivity, sedentary lifestyle and low quality of life. A receiver operation characteristics curve with area under the curve (AUC) value was plotted and each cutoff points' discriminative capacity was calculated. Cox regression and Kaplan-Meier method assessed the association between the cutoff points and mortality. RESULTS: The new cutoff points for FFMI were 14.65 kg/m2 for women (AUC=0.744; sensitivity (Se)=0.88; specificity (Sp)=0.60) and 20.35 kg/m2 for men (AUC=0.565; Se=0.36; Sp=0.81). The new cutoffs were the best to discriminate poor exercise capacity assessed by walked distance in % predicted and quality of life. Only the new cutoff point was associated with mortality (HR=2.123; 95% CI: 1.03-4.33, P=0.039, log rank P=0.035). CONCLUSIONS: Only the new cutoff point was associated with all-cause mortality, and it had the highest discriminating capacity for exercise capacity and quality of life in Brazilian patients with COPD.
Authors: Henrik Watz; Fabio Pitta; Carolyn L Rochester; Judith Garcia-Aymerich; Richard ZuWallack; Thierry Troosters; Anouk W Vaes; Milo A Puhan; Melissa Jehn; Michael I Polkey; Ioannis Vogiatzis; Enrico M Clini; Michael Toth; Elena Gimeno-Santos; Benjamin Waschki; Cristobal Esteban; Maurice Hayot; Richard Casaburi; Janos Porszasz; Edward McAuley; Sally J Singh; Daniel Langer; Emiel F M Wouters; Helgo Magnussen; Martijn A Spruit Journal: Eur Respir J Date: 2014-10-30 Impact factor: 16.671
Authors: Annemie M W J Schols; Roelinka Broekhuizen; Clarie A Weling-Scheepers; Emiel F Wouters Journal: Am J Clin Nutr Date: 2005-07 Impact factor: 7.045
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Authors: Mitja Lainscak; Stephan von Haehling; Wolfram Doehner; Irena Sarc; Tina Jeric; Kristina Ziherl; Mitja Kosnik; Stefan D Anker; Stanislav Suskovic Journal: J Cachexia Sarcopenia Muscle Date: 2011-03-01 Impact factor: 12.910
Authors: Erica P A Rutten; Peter M A Calverley; Richard Casaburi; Alvar Agusti; Per Bakke; Bartolome Celli; Harvey O Coxson; Courtney Crim; David A Lomas; William Macnee; Bruce E Miller; Stephan I Rennard; Paul D Scanlon; Edwin K Silverman; Ruth Tal-Singer; Jørgen Vestbo; Michael L Watkins; Emiel F M Wouters Journal: Ann Nutr Metab Date: 2013-11-07 Impact factor: 3.374