Sarcopenic Obesity, Functional Outcomes, and Systemic Inflammation in Patients With Chronic Obstructive Pulmonary Disease

Pavol Joppa; Ruzena Tkacova; Frits M E Franssen; Corrine Hanson; Stephen I Rennard; Edwin K Silverman; Merry-Lynn N McDonald; Peter M A Calverley; Ruth Tal-Singer; Martijn A Spruit; Klaus Kenn; Emiel F M Wouters; Erica P A Rutten

doi:10.1016/j.jamda.2016.03.020

Sarcopenic Obesity, Functional Outcomes, and Systemic Inflammation in Patients With Chronic Obstructive Pulmonary Disease

J Am Med Dir Assoc. 2016 Aug 1;17(8):712-8. doi: 10.1016/j.jamda.2016.03.020. Epub 2016 May 5.

Authors

Affiliations

¹ Department of Respiratory Medicine, PJ Safarik University, Kosice, Slovakia; Department of Research and Education, CIRO, Horn, Netherlands. Electronic address: joppapavol@gmail.com.
² Department of Respiratory Medicine, PJ Safarik University, Kosice, Slovakia.
³ Department of Research and Education, CIRO, Horn, Netherlands.
⁴ Medical Nutrition Education, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE.
⁵ Division of Pulmonary, Critical Care, Sleep and Allergy, University of Nebraska Medical Center, Omaha, NE; Clinical Discovery Unit, AstraZeneca, Cambridge, UK.
⁶ Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
⁷ Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
⁸ Pulmonary and Rehabilitation Medicine, University of Liverpool, Liverpool, UK.
⁹ GlaxoSmithKline, King of Prussia, PA.
¹⁰ Department of Research and Education, CIRO, Horn, Netherlands; REVAL-Rehabilitation Research Center, BIOMED-Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
¹¹ Department of Respiratory Medicine and Pulmonary Rehabilitation, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany.
¹² Department of Research and Education, CIRO, Horn, Netherlands; Department of Respiratory Medicine, University of Maastricht, Maastricht, Netherlands.

PMID: 27161848
DOI: 10.1016/j.jamda.2016.03.020

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.

Trial registry: ClinicalTrials.gov no. NCT00292552.

Keywords: 6-minute walking distance; Body composition; chronic obstructive pulmonary disease; fibrinogen; sarcopenic obesity; systemic inflammation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Comorbidity*
Female
Health Status
Humans
Inflammation*
Longitudinal Studies
Male
Middle Aged
Multicenter Studies as Topic
Obesity*
Observational Studies as Topic
Pulmonary Disease, Chronic Obstructive*
Sarcopenia*

Associated data

ClinicalTrials.gov/NCT00292552