Mid-Arm Muscle Area Is a Better Predictor of Mortality Than Body Mass Index in COPD

Soler-Cataluña, Juan José; Sánchez-Sánchez, Lourdes; Martínez‐García, Miguel Ángel; Sánchez, Pilar Román; Salcedo, Emmanuel; Navarro, Miriam

doi:10.1378/chest.128.4.2108

Cited by 97 publications

(61 citation statements)

References 34 publications

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“…First, it has been demonstrated that the prevalence of underweight increases with severity of COPD [12] and that fat-free mass decreases in advanced GOLD stages [19]. Furthermore, both gold standard and surrogate parameters of body composition, such as low fat-free mass [4], midthigh muscle cross-sectional area [11] and mid-arm muscle area [20], are better predictors of mortality than BMI. Secondly, our study demonstrates that energy intake is not correlated with disease severity.…”

Section: Discussionmentioning

confidence: 99%

Ageing and COPD affect different domains of nutritional status: the ECCE study

Battaglia¹,

Spatafora²,

Paglino³

et al. 2010

Eur Respir J

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Chronic obstructive pulmonary disease (COPD) and ageing may contribute to malnutrition. We aimed to explore whether COPD and ageing determine malnutrition in different manners.460 stable COPD outpatients (376 males and 84 females) from the Extrapulmonary Consequences of COPD in the Elderly (ECCE) study database were investigated (age 75.0¡5.9 yrs; forced expiratory volume in 1 s 54.7¡18.3% predicted). Nutritional status was evaluated using the Mini Nutritional Assessment1 (MNA) questionnaire. From the MNA, three scores exploring the domains of the nutritional status were calculated: body composition, energy intake and body functionality scores.Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages were negatively correlated with five MNA items exploring mobility, patient's perception of own nutrition and health status, and arm and calf circumferences (lowest Spearman's rho (rs)5 -0.011; highest p50.039). GOLD stages were independently correlated with body composition and body functionality scores (model r 2 50.073). Age was negatively correlated with four MNA items exploring loss of appetite, fluid intake, mobility and autonomy in daily life (lowest rs5 -0.013; highest p50.030). Age was independently correlated with body functionality score (model r 2 50.037). Severe COPD and ageing are independent and probably concurrent conditions leading to malnutrition. The MNA questionnaire allows a valuable insight into the complexity of components of nutritional status and may provide useful clues for treatment strategies.

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Section: Discussionmentioning

confidence: 99%

Ageing and COPD affect different domains of nutritional status: the ECCE study

Battaglia¹,

Spatafora²,

Paglino³

et al. 2010

Eur Respir J

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“…Several European cohort studies (table 1) have shown a link between malnutrition and mortality [91][92][93][94][95]. In the Danish cohort, for patients with an FEV1 ,50% pred the relative risk for death was a HR of 1 …”

Section: Morbidity and Mortalitymentioning

confidence: 97%

Comorbidities of COPD

Cavaillès¹,

Brinchault-Rabin²,

Dixmier³

et al. 2013

Eur Respir Rev

420

285

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By 2020, chronic obstructive pulmonary disease (COPD) will be the third cause of mortality. Extrapulmonary comorbidities influence the prognosis of patients with COPD. Tobacco smoking is a common risk factor for many comorbidities, including coronary heart disease, heart failure and lung cancer. Comorbidities such as pulmonary artery disease and malnutrition are directly caused by COPD, whereas others, such as systemic venous thromboembolism, anxiety, depression, osteoporosis, obesity, metabolic syndrome, diabetes, sleep disturbance and anaemia, have no evident physiopathological relationship with COPD. The common ground between most of these extrapulmonary manifestations is chronic systemic inflammation.All of these diseases potentiate the morbidity of COPD, leading to increased hospitalisations and healthcare costs. They can frequently cause death, independently of respiratory failure. Comorbidities make the management of COPD difficult and need to be evaluated and treated adequately. @ERSpublications Extrapulmonary comorbidities are common in COPD and influence prognosis; we propose an exhaustive comorbidities review

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“…The lower and upper limb muscle mass were estimated, but the measurements we used have traditionally been used in the literature. 30,48 A huge variability was observed for limit of tolerance for the middle deltoid. Our subjects did not undergo muscle biopsy, but a previous study identified 3 patterns of deltoid muscle composition in subjects with COPD 15 : normal size fibers, atrophic fibers, and hypertrophic fibers.…”

Section: Limitationsmentioning

confidence: 98%

Upper and Lower Limb Muscles in Patients With COPD: Similarities in Muscle Efficiency But Differences in Fatigue Resistance

et al. 2013

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BACKGROUND: Peripheral muscle dysfunction is a common finding in patients with COPD; however, the structural adaptation and functional impairment of the upper and lower limb muscles do not seem to be homogenous. We compared muscle fatigue and recovery time between 2 representative muscles: the middle deltoid and the quadriceps femoris. METHODS: Twenty-one subjects with COPD (FEV 1 46.1 ؎ 10.3% of predicted) underwent maximal voluntary isometric contraction and an endurance test (60% of maximal voluntary isometric contraction, to the limit of tolerance). The maximal voluntary isometric contraction test was repeated after 10 min, 30 min, 60 min, and 24 hours for both the quadriceps femoris and middle deltoid. Surface electromyography was recorded throughout the endurance test. RESULTS: Maximal voluntary isometric contraction significantly decreased only for the middle deltoid between 10 and 60 min after the endurance test. A significant increase of the root mean square and a greater decline in median frequency throughout the endurance test occurred for the middle deltoid, compared with the quadriceps femoris. When dyspnea and fatigue scores were corrected by endurance time, higher values were observed for the middle deltoid (0.07 and 0.08, respectively) in relation to the quadriceps femoris (0.02 and 0.03, respectively). CONCLUSIONS: Subjects with COPD had a higher fatigability of a representative upper limb muscle (middle deltoid) than a lower limb muscle (quadriceps femoris).

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Mid-Arm Muscle Area Is a Better Predictor of Mortality Than Body Mass Index in COPD

Cited by 97 publications

References 34 publications

Ageing and COPD affect different domains of nutritional status: the ECCE study

Ageing and COPD affect different domains of nutritional status: the ECCE study

Comorbidities of COPD

Upper and Lower Limb Muscles in Patients With COPD: Similarities in Muscle Efficiency But Differences in Fatigue Resistance

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