TY - JOUR
T1 - Clinical impact of body composition phenotypes in patients with COPD
T2 - a retrospective analysis
AU - Machado, Felipe V. C.
AU - Schneider, Lorena P.
AU - Fonseca, Jessica
AU - Belo, Leticia F.
AU - Bonomo, Camila
AU - Morita, Andrea A.
AU - Furlanetto, Karina C.
AU - Felcar, Josiane M.
AU - Rodrigues, Antenor
AU - Franssen, Frits M. E.
AU - Spruit, Martijn A.
AU - Pitta, Fabio
AU - Hernandes, Nidia A.
PY - 2019/11
Y1 - 2019/11
N2 - Background/Objectives Abnormal body composition is an independent determinant of COPD outcomes. To date, it is already known that patient stratification into body composition phenotypes are associated with important outcomes, such as exercise capacity and inflammation, but there are no data comparing physical activity and muscle strength among these phenotypes. Thus, the aim of this study was to compare clinical characteristics and physical function in patients with COPD stratified into body composition phenotypes.Subjects/Methods Two-hundred and seventy stable COPD patients were classified according to the 10th and 90th percentiles of sex-age-BMI-specific reference values for fat-free and fat mass indexes into four groups: Normal body composition (NBC), Obese, Sarcopenic, and Sarcopenic-obese (SO). Patients underwent assessment of exercise capacity, peripheral and respiratory muscle strength, physical activity, dyspnea severity, functional status, and symptoms of anxiety and depression.Results The prevalence of patients classified as NBC, Obese, Sarcopenic, and SO was 39%, 13%, 21%, or 27%, respectively. SO presented lower 6MWT compared with NBC (P <0.05). Sarcopenic and SO groups presented worse muscle strength compared with NBC (P <0.05). Sarcopenic group presented more time in moderate-to-vigorous physical activity compared to all other groups (P <0.05) and less sedentary time when compared with NBC and obese groups (P <0.05). There were no differences regarding dyspnea severity, functional status, and symptoms of anxiety and depression (P > 0.16). Sarcopenic and SO groups had, respectively, 7.8 [95% CI: 1.6-37.7] and 9.5 [2.2-41.7] times higher odds to have a 6MWT equal or lower to 350 meters.Conclusions Body composition phenotypes are associated with physical function in patients with COPD. Sarcopenic-obese patients were the most impaired.
AB - Background/Objectives Abnormal body composition is an independent determinant of COPD outcomes. To date, it is already known that patient stratification into body composition phenotypes are associated with important outcomes, such as exercise capacity and inflammation, but there are no data comparing physical activity and muscle strength among these phenotypes. Thus, the aim of this study was to compare clinical characteristics and physical function in patients with COPD stratified into body composition phenotypes.Subjects/Methods Two-hundred and seventy stable COPD patients were classified according to the 10th and 90th percentiles of sex-age-BMI-specific reference values for fat-free and fat mass indexes into four groups: Normal body composition (NBC), Obese, Sarcopenic, and Sarcopenic-obese (SO). Patients underwent assessment of exercise capacity, peripheral and respiratory muscle strength, physical activity, dyspnea severity, functional status, and symptoms of anxiety and depression.Results The prevalence of patients classified as NBC, Obese, Sarcopenic, and SO was 39%, 13%, 21%, or 27%, respectively. SO presented lower 6MWT compared with NBC (P <0.05). Sarcopenic and SO groups presented worse muscle strength compared with NBC (P <0.05). Sarcopenic group presented more time in moderate-to-vigorous physical activity compared to all other groups (P <0.05) and less sedentary time when compared with NBC and obese groups (P <0.05). There were no differences regarding dyspnea severity, functional status, and symptoms of anxiety and depression (P > 0.16). Sarcopenic and SO groups had, respectively, 7.8 [95% CI: 1.6-37.7] and 9.5 [2.2-41.7] times higher odds to have a 6MWT equal or lower to 350 meters.Conclusions Body composition phenotypes are associated with physical function in patients with COPD. Sarcopenic-obese patients were the most impaired.
KW - FAT-FREE MASS
KW - RESPIRATORY SOCIETY STATEMENT
KW - AIR-FLOW OBSTRUCTION
KW - PHYSICAL-ACTIVITY
KW - PULMONARY REHABILITATION
KW - EXERCISE CAPACITY
KW - DAILY-LIFE
KW - VALIDATION
KW - OBESITY
KW - SARCOPENIA
U2 - 10.1038/s41430-019-0390-4
DO - 10.1038/s41430-019-0390-4
M3 - Article
VL - 73
SP - 1512
EP - 1519
JO - European Journal of Clinical Nutrition
JF - European Journal of Clinical Nutrition
SN - 0954-3007
IS - 11
ER -