Chronic obstructive pulmonary disease (COPD) has been described as a systemic disease. Sarcopenia is one of the systemic effects that is related to several adverse outcomes. The objectives of this study were to estimate the prevalence of sarcopenia and to determine the factors associated with sarcopenia in COPD patients in Southeast Asia. This was a cross-sectional study of COPD patients who attended a COPD clinic from May 2015 to December 2016. Baseline characteristics were collected and dual-energy X-ray absorptiometry was used to measure skeletal muscle mass. Handgrip strength was used to assess muscle strength, and as a measurement of physical performance, the 6-min walk distance was used. One hundred and twenty-one participants were recruited. Most of them were men (92.6%). Prevalence of sarcopenia was 24% (29 cases). Independent factors associated with sarcopenia were age ≥ 75 years (adjusted odds ratio (AOR) 13.3, severity of COPD (AOR 19.2 and 13.4 for moderate and severe COPD), Modified Medical Research Council (MMRC) scale (AOD 1.9), and obesity (AOR 0.04). Sarcopenia affects about one-quarter of COPD patients. Age, severity of COPD, MMRC scale, and BMI status were the factors associated with sarcopenia.

Frailty is a state of increased risk of unfavorable outcomes when exposed to stressors, and COPD is one of the several chronic illnesses associated with the condition. However, few studies have been conducted regarding the prevalence of COPD and its related factors in Southeast Asia. The objectives of this study were to determine the prevalence of frailty in COPD patients and to identify the associated factors in these populations. A cross-sectional study of COPD patients who attended a COPD clinic was conducted from May 2015 to December 2016. Baseline characteristics were collected, and the diagnosis of frailty was based on the FRAIL (fatigue, resistance, ambulation, illnesses, and loss of weight) scale. Descriptive statistics were used to analyze baseline data. Factors associated with frailty were analyzed using univariate and multivariate regression analyses. The results showed that the prevalence rates of frailty and pre-frailty were 6.6% (eight out of 121 cases) and 41.3% (50 out of 121 cases), respectively, among COPD patients. Fatigue was the most common component of the FRAIL scale that was found more frequently in frail patients than in non-frail patients (odds ratio [OR] 91.9). Factors associated with frailty according to multivariate analyses were comorbid cancer (adjusted OR [AOR] 45.8), at least two instances of nonelective admission over the past 12 months (AOR 112.5), high waist circumference (WC) (AOR 1.3), and presence of sarcopenia (AOR 29.5). In conclusion, frailty affected 6.6% of stable COPD patients. Cancer, two or more instances of nonelective hospitalization over the past 12 months, high WC, and presence of sarcopenia were associated with frailty. Early identification and intervention in high-risk patients is recommended to prevent or delay the adverse outcomes of frailty.

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Chindaprasirt et al.: Bone mass content in COPD The objectives of this study were to determine the distributions of weight-adjusted bone mass content and osteoporosis in chronic obstructive pulmonary disease patients, to examine the prevalence of osteoporosis and osteopenia and to determine factors associated with weight-adjusted bone mass content. A crosssectional study of chronic obstructive pulmonary disease patients at a tertiary-care hospital, Thailand was conducted from May 2015 to December 2016. Baseline characteristics were collected and bone mineral density and weight-adjusted bone mass content were measured using dual-energy X-ray absorptiometry. A total of 107 chronic obstructive pulmonary disease patients were included. The prevalence of osteoporosis and osteopenia were 35.5 and 38.2 %, respectively. The distribution of weight-adjusted bone mass content of arms, legs and whole body was significantly correlated with chronic obstructive pulmonary disease severity (p<0.05), but not with the presence of osteoporosis. Factors associated with weight-adjusted bone mass content of the extremities was the severity of chronic obstructive pulmonary disease (adjusted odds ratios of moderate and severe chronic obstructive pulmonary disease were 1.03 and 1.06), waist circumference (adjusted odds ratio 0.99) and appendicular skeletal mass index (adjusted odds ratio 0.98). Both osteoporosis and osteopenia were present in more than a third of the chronic obstructive pulmonary disease patients. The weight-adjusted bone mass content of arms, legs, extremities and whole body were correlated with the degree of airflow limitation but not the presence of osteoporosis. Factors associated with weight-adjusted bone mass content of the extremities were identified. Weight-adjusted bone mass content could be a good index to indicate the degree of bone loss in chronic obstructive pulmonary disease patients.