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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/22545

Title: Sarcopenic Obesity, Functional Outcomes, and Systemic Inflammation in Patients With Chronic Obstructive Pulmonary Disease
Authors: Joppa, Pavol
Tkacova, Ruzena
Franssen, Frits M. E.
Hanson, Corrine
Rennard, Stephen I.
Silverman, Edwin K.
McDonald, Merry-Lynn N.
Calverley, Peter M. A.
Tal-Singer, Ruth
Spruit, Martijn A.
Kenn, Klaus
Wouters, Emiel F. M.
Rutten, Erica P. A.
Issue Date: 2016
Publisher: ELSEVIER SCIENCE INC
Citation: JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION, 17(8), p. 712-718
Abstract: Background: Both loss of muscle mass (ie, sarcopenia) and obesity adversely impact clinically important outcomes in patients with chronic obstructive pulmonary disease (COPD). Currently, there are only a few studies in patients with COPD with sarcopenia and concurrent obesity, termed sarcopenic obesity (SO). Objective: To explore the effects of SO on exercise capacity, health status, and systemic inflammation in COPD. Design/Settings/Participants: Baseline data collected from a total of 2548 participants (2000 patients with COPD, mean age (SD), 63.5 (7.1) years; and 548 controls, 54.8 (9.0) years) from ECLIPSE (Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints) study, a multicenter longitudinal observational study, were used. Measurements: All participants were divided into 4 body composition phenotypes using bioelectrical impedance analysis: (1) normal body composition, (2) obesity, (3) sarcopenia, and (4) SO. In patients with COPD, the 6-minute walking distance, disease-specific health status, and plasma inflammatory markers were compared among the respective body composition groups. Results: Patients with COPD were 3 times more likely to present with SO compared with controls without COPD (odds ratio [OR] 3.3, 95% confidence interval [CI] 2.0-5.4, P <.001). In patients with COPD, SO was related to reduced 6-minute walking distance (-28.0 m, 95% CI -45.6 to -10.4), P <.01) and to higher systemic inflammatory burden (an elevation of at least 2 inflammatory markers, OR 1.6, 95% CI 1.1-2.5, P =.028) compared with the normal body composition group after adjustments for age, sex, smoking, body mass index, and airflow limitation. Conclusions: Our findings suggest that SO is associated with worse physical performance and higher systemic inflammatory burden compared with other body composition phenotypes in patients with COPD. (C) 2016 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
Notes: [Joppa, Pavol; Tkacova, Ruzena] Safarik Univ, Dept Resp Med, Kosice, Slovakia. [Joppa, Pavol; Franssen, Frits M. E.; Spruit, Martijn A.; Wouters, Emiel F. M.; Rutten, Erica P. A.] CIRO, Dept Res & Educ, Horn, Netherlands. [Hanson, Corrine] Univ Nebraska Med Ctr, Coll Allied Hlth Profess, Med Nutr Educ, Omaha, NE USA. [Rennard, Stephen I.] Univ Nebraska Med Ctr, Div Pulm Crit Care Sleep & Allergy, Omaha, NE USA. [Rennard, Stephen I.] AstraZeneca, Clin Discovery Unit, Cambridge, England. [Silverman, Edwin K.; McDonald, Merry-Lynn N.] Harvard Med Sch, Brigham & Womens Hosp, Channing Div Network Med, Boston, MA USA. [Silverman, Edwin K.] Harvard Med Sch, Brigham & Womens Hosp, Div Pulm & Crit Care Med, Boston, MA USA. [Calverley, Peter M. A.] Univ Liverpool, Pulm & Rehabil Med, Liverpool, Merseyside, England. [Tal-Singer, Ruth] GlaxoSmithKline, King Of Prussia, PA USA. [Spruit, Martijn A.] Hasselt Univ, Fac Med & Life Sci, BIOMED Biomed Res Inst, REVAL Rehabil Res Ctr, Diepenbeek, Belgium. [Kenn, Klaus] Schoen Klin Berchtesgadener Land, Dept Resp Med & Pulm Rehabil, Schoenau, Germany. [Wouters, Emiel F. M.] Maastricht Univ, Dept Resp Med, Maastricht, Netherlands.
URI: http://hdl.handle.net/1942/22545
DOI: 10.1016/j.jamda.2016.03.020
ISI #: 000380759700008
ISSN: 1525-8610
Category: A1
Type: Journal Contribution
Validation: ecoom, 2017
Appears in Collections: Research publications

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