Felipe V C Machado1,2,3,4, Martijn A Spruit5,6,7, Miriam T J Groenen5, Sarah Houben-Wilke5, Paula P van Melick5, Nidia A Hernandes8, Annemie M W J Schols6,7, Fabio Pitta8, Emiel F M Wouters5,7,9, Frits M E Franssen5,6,7. 1. Department of Research and Development, CIRO+, Centre of Expertise for Chronic Organ Failure, 6080 AB Haelen, Hornerheide 1, Postbus 4009, 6085 NM, Horn, The Netherlands. felipemachado@ciro-horn.nl. 2. NUTRIM-School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands. felipemachado@ciro-horn.nl. 3. Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands. felipemachado@ciro-horn.nl. 4. Laboratory of Research in Respiratory Physiotherapy, Department of Physical Therapy, State University of Londrina, Londrina, Brazil. felipemachado@ciro-horn.nl. 5. Department of Research and Development, CIRO+, Centre of Expertise for Chronic Organ Failure, 6080 AB Haelen, Hornerheide 1, Postbus 4009, 6085 NM, Horn, The Netherlands. 6. NUTRIM-School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands. 7. Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands. 8. Laboratory of Research in Respiratory Physiotherapy, Department of Physical Therapy, State University of Londrina, Londrina, Brazil. 9. Ludwig Boltzmann Institute for Lung Health, Vienna, Austria.
Abstract
BACKGROUND: Cut offs for fat-free mass index (FFMI) and appendicular skeletal muscle mass index (ASMI) are available for diagnosing low muscle mass in patients with COPD. This study aimed to investigate: (1) the frequency of low muscle mass (FFMI and ASMI) applying different cut-offs and (2) the functional translation (clinical impact) of low muscle mass, in patients with COPD stratified into BMI categories. METHODS: Patients with COPD were assessed regarding body composition, exercise capacity, quadriceps muscle strength, symptoms of anxiety and depression, dyspnea and quality of life upon referral to pulmonary rehabilitation. The proportion of patients with low muscle mass was compared among BMI categories. Clinical outcomes between patients with normal and low muscle mass within each BMI category were compared. RESULTS: 469 patients with COPD were included for analyses. The frequency of patients classified as low FFMI varied significantly according to the choice of cut-off (32 to 54%; P < 0.05), whereas the frequency of patients with low ASMI was 62%. When applying age-gender-BMI-specific cut-offs, 254 patients (54%) were classified as low FFMI. The choice of the cut-off affected the frequency of patients with low muscle mass in all BMI categories. Overweight and obese patients with low muscle mass were more frequently males and presented worse pulmonary function, exercise capacity and muscle strength compared with overweight and obese patients with normal muscle mass. CONCLUSIONS: Approximately half of the overweight and obese patients with COPD have low muscle mass when applying age-gender-BMI-specific cut-offs. Low muscle mass is associated with worse functional outcomes in overweight and obese COPD patients.
BACKGROUND: Cut offs for fat-free mass index (FFMI) and appendicular skeletal muscle mass index (ASMI) are available for diagnosing low muscle mass in patients with COPD. This study aimed to investigate: (1) the frequency of low muscle mass (FFMI and ASMI) applying different cut-offs and (2) the functional translation (clinical impact) of low muscle mass, in patients with COPD stratified into BMI categories. METHODS:Patients with COPD were assessed regarding body composition, exercise capacity, quadriceps muscle strength, symptoms of anxiety and depression, dyspnea and quality of life upon referral to pulmonary rehabilitation. The proportion of patients with low muscle mass was compared among BMI categories. Clinical outcomes between patients with normal and low muscle mass within each BMI category were compared. RESULTS: 469 patients with COPD were included for analyses. The frequency of patients classified as low FFMI varied significantly according to the choice of cut-off (32 to 54%; P < 0.05), whereas the frequency of patients with low ASMI was 62%. When applying age-gender-BMI-specific cut-offs, 254 patients (54%) were classified as low FFMI. The choice of the cut-off affected the frequency of patients with low muscle mass in all BMI categories. Overweight and obesepatients with low muscle mass were more frequently males and presented worse pulmonary function, exercise capacity and muscle strength compared with overweight and obesepatients with normal muscle mass. CONCLUSIONS: Approximately half of the overweight and obesepatients with COPD have low muscle mass when applying age-gender-BMI-specific cut-offs. Low muscle mass is associated with worse functional outcomes in overweight and obese COPDpatients.
Entities:
Keywords:
Exercise tolerance; Obesity; Prevalence; Quality of life; Sarcopenia
Authors: Jørgen Vestbo; Eva Prescott; Thomas Almdal; Morten Dahl; Børge G Nordestgaard; Teis Andersen; Thorkild I A Sørensen; Peter Lange Journal: Am J Respir Crit Care Med Date: 2006-01-01 Impact factor: 21.405