Decreased Tongue Strength is Related to Skeletal Muscle Mass in COPD Patients

Abstract

Dysphagia is frequently observed in patients with chronic obstructive pulmonary disease (COPD). Decreased tongue strength is one of the causes of dysphagia, and it is often observed in patients with sarcopenia. Sarcopenia is also frequently observed in COPD patients. We hypothesized that tongue strength is lower in COPD patients compared to normal subjects. This was a single-center, observational, cross-sectional study. Maximum tongue pressure (MTP) was measured in 27 patients with COPD and 24 age-matched control subjects. We also evaluated handgrip strength, gait speed, and appendicular skeletal muscle mass to define subjects as having sarcopenia. We used bioelectrical impedance analysis to assess body composition. The eating assessment test-10 was used to diagnose dysphagia. MTP was significantly lower in COPD patients than in control subjects (33.8 ± 8.4 vs 38.0 ± 5.3; p = 0.032). All measures of muscle and fat free body mass, handgrip strength, and gait speed were also significantly lower in COPD patients compared to control subjects ( p < 0.01). The prevalence of sarcopenia in COPD patients was higher than that in control subjects (6/27 versus 0/24; p = 0.007), but the prevalence of dysphagia was not different between groups (COPD: 5/27, versus control: 1/24; p = 0.112). MTP was moderately correlated with skeletal muscle mass index ( r = 0.56, p = 0.003) and handgrip strength ( r = 0.43, p = 0.027) in COPD patients. Tongue strength was lower in COPD patients compared to normal subjects, and decreased tongue strength may be correlated with sarcopenia in COPD patients. Supplementary Information The online version contains supplementary material available at 10.1007/s00455-021-10314-3.

Relationship between tongue pressure and handgrip strength: A systematic review and meta‐analysis

“…Previous evidence on a correlation between HGS and TP is indecisive 22,30,31,33,42–53 . In the present meta‐analysis, TP was used as dependent variable and HGS was used as an independent variable, that is the estimated coefficient shows the influence (effect) of handgrip strength on tongue pressure.…”

“…Previous evidence on a correlation between HGS and TP is indecisive. 22,30,31,33,[42][43][44][45][46][47][48][49][50][51][52][53] In the present meta-analysis, TP was used as dependent variable and HGS was used as an independent variable, that is the estimated coefficient shows the influence (effect) of handgrip An accumulated poor oral status including low TP was reported to significantly predict future physical weakening (new onsets of physical frailty, sarcopaenia and disability), 7 and low TP would significantly hinder food bolus formation and propagation, thus leading to malnourishment following decreased oral intake. 45,54 A decrease in the food intake diversity is considered to be a risk to decrease the limb skeletal muscle mass.…”

“…Previous evidence on a correlation between HGS and TP is indecisive. 22 , 30 , 31 , 33 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 In the present meta‐analysis, TP was used as dependent variable and HGS was used as an independent variable, that is the estimated coefficient shows the influence (effect) of handgrip strength on tongue pressure. Significant correlations between HGS and TP could be shown in independent group ( p = .001), in requiring nursing care group ( p = .024) and in older adults' group ( p < .001), but not in young group ( p = .053) as the p ‐value was just above the level of significance.…”

A Missing Voice: The Lingual Complex and Osteopathic Manual Medicine in the Context of Five Osteopathic Models

“…Lingual dysfunction may occur following a prolonged position with the patient prone, following pneumonia due to severe acute respiratory syndrome coronavirus 2 infection; lingual functional impairment can have serious consequences for the patient's health [81]. Similarly, with chronic pulmonary diseases such as chronic obstructive pulmonary disease and asthma, there are abnormal lingual movements, a functional decline in the strength and activity of the tongue, which reflects the decline in muscle strength of the limbs [82][83][84].…”

Lower SMI is a risk factor for dysphagia in Japanese hospitalized patients with osteoporotic vertebral and hip fracture: A retrospective study

“…Dysphagia in sarcopenia is called sarcopenic dysphasia, and refers to a condition wherein eating and swallowing functions are impaired due to an overall decrease in skeletal muscle strength and muscle mass and has recently come to be regarded as a disease concept [ 3 , 4 ]. Sarcopenic dysphagia has been reported to coexist with various diseases such as dementia, liver cirrhosis, chronic obstructive pulmonary disease (COPD), and COVID-19 [ [5] , [6] , [7] , [8] ]. Since most patients with sarcopenic dysphagia are elderly and may therefore have a high risk of fragile fractures due to osteoporosis.…”