Body composition and sarcopenia in patients with chronic obstructive pulmonary disease

Costa, Tommaso; Costa, Fabio Marcelo; Jonasson, T. Hoffman; Moreira, Carolina Aguiar; Boguszewski, César Luiz; Borba, Victória Zeghbi Cochenski

doi:10.1007/s12020-018-1533-4

Cited by 39 publications

(43 citation statements)

References 37 publications

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“…Our data show that SI is lower in COPD patients compared to age- and sex-matched healthy controls. This result is concordant with previous studies comparing muscle mass in COPD patients versus healthy controls using other techniques [26]. …”

Section: Discussionsupporting

confidence: 93%

The Ratio Serum Creatinine/Serum Cystatin C (a Surrogate Marker of Muscle Mass) as a Predictor of Hospitalization in Chronic Obstructive Pulmonary Disease Outpatients

et al. 2018

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Background: In chronic obstructive pulmonary disease (COPD), low muscle mass has been associated with several clinical outcomes such as low exercise capacity, hospital admission, and mortality. The Sarcopenia Index (SI) is a novel way to estimate muscle mass based on the ratio of serum creatinine (produced exclusively by muscle)/cystatin C (produced by all nucleated body cells). Objectives: This study aims to assess the SI in stable COPD outpatients, as compared with a healthy control group, to quantify its relationship with several important clinical features in COPD, and to study its potential usefulness to predict COPD exacerbations and hospital admissions. Methods: The SI was calculated in 18 healthy control subjects and 65 stable COPD outpatients were included in the study. Patients were prospectively followed for 1 year after being enrolled in the study. Results: COPD patients had a lower SI than controls, that is lower muscle mass. Furthermore, patients with a modified Medical Research Council dyspnea score ≥2, patients with a COPD Assessment Test score ≥10, and patients with a high risk of exacerbation had lower levels of SI compared with patients without these characteristics. SI correlated with FEV1 (r = 0.491, p < 0.001), the 6-min walking test (r = 0.560, p = 0.001), and the Fat-Free Mass Index (r = 0.431, p = 0.017). Univariate and multivariate Cox proportional risk analysis showed that a low SI is an independent predictor of hospital admission in COPD outpatients followed for 1 year (HR 5.16, p = 0.025). Conclusions: The ratio serum creatinine/serum cystatin C correlates with several COPD characteristics, and it can be used to predict COPD hospitalization.

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Section: Discussionsupporting

confidence: 93%

The Ratio Serum Creatinine/Serum Cystatin C (a Surrogate Marker of Muscle Mass) as a Predictor of Hospitalization in Chronic Obstructive Pulmonary Disease Outpatients

et al. 2018

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“…Our search yielded 4465 records, of which 2315 duplicates were removed, resulting in 2150 unique articles. We read the full text of 62 articles, and determined that 10 of them were eligible for inclusion in this meta-analysis (figure 1) [55][56][57][58][59][60][61][62][63][64].…”

Section: Search Resultsmentioning

confidence: 99%

“…Among the 10 eligible studies published between 2012 and 2018, six were performed only in COPD patients without a control group [55-57, 59, 60, 63], two reported data on population-based prevalence [58,61] and two were nursing home based [62,64]. Four studies were from Europe [55,58,63,64], four from Asia [57,59,60,62] and two from South America [56,61]. The total number of COPD participants involved in all selected studies was 2565, with a mean age ranging from 62 to 84 years at study entry (table 2).…”

Section: Characteristics Of Studies Includedmentioning

confidence: 99%

“…Eight of the selected studies used the EWGSOP definition of sarcopenia [55,[58][59][60][61][62][63][64], and two of them applied the Foundation for the National Institutes of Health (FNIH) and the Asian Working Group on Sarcopenia consensus (table 1) [56,57]. When we analysed the components of sarcopenia in these 10 studies, we found large variability in the methods and cut-off points, especially for lean mass.…”

Section: Characteristics Of Studies Includedmentioning

confidence: 99%

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Sarcopenia in COPD: a systematic review and meta-analysis

et al. 2019

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COPD is associated with a progressive loss of muscle mass and function. However, there is an unmet need to define and standardise methods to estimate the prevalence of sarcopenia in COPD patients.We performed a systematic review and meta-analysis of the prevalence of this extrapulmonary manifestation in COPD patients. We searched Embase, Medline (Ovid), CINAHL (EBSCO), Web of Science, Scopus and Google Scholar for studies published up to January 17, 2019, assessing sarcopenia in COPD patients based on low muscle mass and decreased muscle function. Interventional studies, in vitro experiments, protocols or reviews and meta-analyses were excluded. We estimated heterogeneity (I2) and assessed significance (Q) using a Chi-squared test for estimates obtained from random-effects models.4465 articles were initially identified. After removing the duplicates and applying the selection criteria, we reviewed 62 full-text articles. Finally, 10 articles (n=2565 COPD patients) were included in this systematic review and meta-analyses. Overall, the prevalence of sarcopenia in patients with COPD was 21.6% (95% CI 14.6–30.9%, I2=94%), ranging from 8% in population-based to 21% in clinic-based studies, and 63% in COPD patients residing in nursing homes.Sarcopenia is frequently observed in COPD patients, with varying prevalence across population settings. Sarcopenia in COPD should be assessed using standardised tests and cut-off points from sarcopenia consensus criteria for clinical practice and international comparisons.

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“…The progressive loss of weight, lean and fat mass, in COPD is the result of increased catabolic demand from the respiratory muscles, elevated levels of proinflammatory cytokines and oxidative stress, hypoxemia and smoking (24). The frequency of sarcopenia in patients with COPD ranges around 12-20% and is associated with a worse prognosis (25) and disease severity (26). In chronic kidney disease (CKD) patients, the MM loss presents earlier and much more markedly than in subjects without chronic illnesses.…”

Section: Sarcopenia In Non-endocrine Diseasesmentioning

confidence: 99%

MECHANISMS OF ENDOCRINE DISEASE: Sarcopenia in endocrine and non-endocrine disorders

Borba

Costa

Moreira

et al. 2019

European Journal of Endocrinology

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Objective This paper reviews the main mechanisms, diagnostic criteria, treatment options and available data on sarcopenia in endocrine and non-endocrine disorders. The literature notes the presence of sarcopenia as a comorbid condition or a complication of another clinical situation and not a disease that only affects elderly patients. Method We performed a literature review, focusing on the following: mechanisms related to sarcopenia in elderly patients, and sarcopenia as it presents in the context of chronic and endocrine diseases; diagnostic tools and methods; aspects of sarcopenia and treatment options specific to chronic diseases and endocrine disorders respectively. Results Sarcopenia in chronic and endocrine disorders shares many mechanisms with sarcopenia affecting elderly patients, but certain diseases can have a predominant aspect that leads to sarcopenia. The prevalence of sarcopenia varies, depending on different diagnostic criteria, from around 12 to 60% in chronic illnesses and 15 to 90% in endocrine disorders. The interplay between sarcopenia, chronic diseases and elderly patients requires further study, to clarify the impact of each, in terms of prognosis and mortality. Conclusion Awareness of the presentation of sarcopenia in the context of other diseases and ages (and not just the elderly) is fundamental to ensure that preventive measures can be deployed.

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Body composition and sarcopenia in patients with chronic obstructive pulmonary disease

Abstract: This study showed alterations in body composition parameters in patients with COPD. A high prevalence of sarcopenia and the association with worse prognostic index.

Cited by 39 publications

References 37 publications

The Ratio Serum Creatinine/Serum Cystatin C (a Surrogate Marker of Muscle Mass) as a Predictor of Hospitalization in Chronic Obstructive Pulmonary Disease Outpatients

The Ratio Serum Creatinine/Serum Cystatin C (a Surrogate Marker of Muscle Mass) as a Predictor of Hospitalization in Chronic Obstructive Pulmonary Disease Outpatients

Sarcopenia in COPD: a systematic review and meta-analysis

MECHANISMS OF ENDOCRINE DISEASE: Sarcopenia in endocrine and non-endocrine disorders

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