Antagonistic implications of sarcopenia and abdominal obesity on physical performance in COPD

Abstract

Decreased physical performance due to loss of muscle mass (i.e. sarcopenia) is prevalent in ageing and appears more pronounced in chronic disease. A comprehensive profile of the sarcopenic phenotype in chronic obstructive pulmonary disease (COPD) is not yet available. The aim of the present study was to characterise prevalence, functional implications and predictive value of sarcopenia with or without abdominal obesity in Dutch COPD patients eligible for pulmonary rehabilitation.505 COPD patients (aged 37-87 years; 57% male) underwent assessment of lung function, body composition and physical functioning, before entering pulmonary rehabilitation. Sarcopenia was assessed by appendicular skeletal muscle index (ASMI) and abdominal obesity by android/gynoid percentage fat mass (A/G%FM) using dual energy X-ray absorptiometry.86.5% of patients were sarcopenic and showed lower physical functioning, while coexistent abdominal obesity (78.0%) resulted in higher physical functioning. Implications on endurance were less pronounced in women. The predictive value for physical functioning was higher for the "three-compartment" model (ASMI, bone mineral content and A/G%FM) than the "two-compartment" model (fat-free mass index and fat mass index) or "one-compartment" model (body mass index).In patients eligible for pulmonary rehabilitation, sarcopenia is highly prevalent in all body mass index categories and associated with impaired strength, and in men also with decreased endurance. Abdominal obesity seems to have protective effects on physical functioning. ASMI is a better predictor for physical functioning than fat-free mass index. @ERSpublications Highly prevalent sarcopenia and abdominal obesity in COPD patients exert antagonistic effects on physical functioning http://ow.ly/L5b9r

Inflammation and sarcopenia: A systematic review and meta-analysis

“…After excluding 978 papers through title and abstract review, 38 full text articles were examined. Altogether, 19 studies were included in the qualitative synthesis [11], [19]- [36] and 17 in meta-analysis [20]- [36] (eFigure 1).…”

“…The 17 meta-analyzed studies [20]- [36] included a total of 11249 participants (3072 with sarcopenia and 8177 without). The majority of the studies were conducted in Asia and among outpatients (eTable 1).…”

“…Pooling data from 16 studies [20]- [33], [35], [36], people with sarcopenia (n=3391) were significantly more likely than those without sarcopenia (n=7658) to have significantly higher levels of CRP (SMD=0.51; 95%CI: 0.26, 0.77; p<0.0001; I 2 =96%) (Figure 1). On the contrary, serum IL6 levels did not differ between people with sarcopenia (n=1113) versus those with sarcopenia (n=1981) (7 studies [22], [26], [29], [30], [33]- [35]; SMD=0.35; 95%CI: -0.19, 0.89; p=0.21; I 2 =97%) (Figure 2).…”

Obesity in COPD: to treat or not to treat?

“…The burden of COPD with coexisting obesity is amplified, as patients with both conditions may experience increased health-care utilization, have worse dyspnea and poorer healthrelated quality of life, more marked reduction in functional capacity, and increased physical inactivity [7]. In addition, sarcopenia remains common in obesity and is associated with poor functional outcomes [9].…”

The Ratio Serum Creatinine/Serum Cystatin C (a Surrogate Marker of Muscle Mass) as a Predictor of Hospitalization in Chronic Obstructive Pulmonary Disease Outpatients

“…Sarcopenia measured by DEXA, CT or MRI, and low Fat-Free Mass Index (FFMI) (a surrogate marker of muscle mass) measured by electric bioimpedance, have been associated with clinically important outcomes such as hospitalizations [5], mortality [6], and several other outcomes in COPD patients [7-9]. …”