Clinical impact of body composition phenotypes in patients with COPD: a retrospective analysis

Machado, Felipe; Schneider, Lorena Paltanin; Fonseca, Jéssica; Belo, Letícia Fernandes; Bonomo, Camila; Morita, Andrea Akemi; Furlanetto, Karina Couto; Felcar, Josiane Marques; Rodrigues, Antenor; Franssen, Frits M.E.; Spruit, Martijn A.; Pitta, Fábio; Hernandes, Nídia A.

doi:10.1038/s41430-019-0390-4

Cited by 23 publications

(21 citation statements)

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“…Patients with COPD present chronic airflow obstruction and respiratory symptoms; however, there is a substantial variation in risk of exacerbations, exercise capacity, level of physical activity and other characteristics among patients 1 . Thus, COPD is considered a complex and heterogeneous disease and studies have identified different patients' clusters based on a comprehensive assessment of lung function, 2 response to pulmonary rehabilitation, 3 comorbidities, 4,5 physical activity 6 and body composition 7,8 …”

Section: Introductionmentioning

confidence: 99%

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Longitudinal changes in total and regional body composition in patients with chronic obstructive pulmonary disease

et al. 2021

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Background and objective Low fat‐free mass (FFM) is common in patients with chronic obstructive pulmonary disease (COPD) and contributes to morbidity and mortality. Few studies have evaluated longitudinal changes in body composition in patients with COPD compared with non‐COPD controls. This study aimed to compare longitudinal changes in total and regional body composition between patients with COPD and non‐COPD controls and investigate predictors of changes in body composition in COPD. Methods Patients with COPD and non‐COPD controls participating in the Individualized COPD Evaluation in relation to Ageing (ICE‐Age) study, a single‐centre, longitudinal, observational study, were included. Subjects were assessed at baseline and after 2 years of follow‐up. Among other procedures, body composition was measured by dual‐energy X‐ray absorptiometry scan. The number of exacerbations/hospitalizations 1 year before inclusion and during follow‐up were assessed in patients with COPD. Results A total of 405 subjects were included (205 COPD, 87 smoking and 113 non‐smoking controls). Patients with COPD and smoking controls presented a significant decline in total FFM (mean [95% CI]: −1173 [−1527/−820] g and −486 [−816/−156] g, respectively) while body composition remained stable in non‐smoking controls. In patients with COPD, the decline in FFM was more pronounced in legs (−174 [−361/14] g) and trunk (−675 [−944/406] g) rather than in arms (54 [−19/126] g). The predictors of changes in total and regional FFM in patients with COPD were gender, number of previous hospitalizations, baseline values of FFM and BMI. Conclusion Patients with COPD present a significant decline in FFM after 2 years of follow‐up, this decline is more pronounced in their legs and trunk.

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Section: Introductionmentioning

confidence: 99%

“…1 Thus, COPD is considered a complex and heterogeneous disease and studies have identified different patients' clusters based on a comprehensive assessment of lung function, 2 response to pulmonary rehabilitation, 3 comorbidities, 4 , 5 physical activity 6 and body composition. 7 , 8 …”

Section: Introductionmentioning

confidence: 99%

Longitudinal changes in total and regional body composition in patients with chronic obstructive pulmonary disease

et al. 2021

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“…Yüz sekiz akciğer nakil adayı üzerinde yapılmış olan bir çalışmada periferik kas kuvvetinin 6-dakika yürüme mesafesinin bir prediktörü olabileceği, QF kuvvetlendirme egzersizlerinin PR programları içerisine dahil edilmesi gerektiği vurgulanmıştır (4) Vücut kompozisyonu ve özellikle kas kütlesi, fiziksel fonksiyonları etkileyen parametrelerdir. KOAH'lılar üzerinde yapılan bir çalışmada normal, sarkopenik ve obez sarkopenik hasta gruplarının egzersiz kapasitesi, solunum ve periferik kas kuvvetleri karşılaştırılmış, obez sarkopenik grubun fiziksel fonksiyonlarının daha kötü olduğu ve kas kütlesinin fiziksel statüyü etkilediği sonucu çıkartılmıştır (16). Bekleme listesindeki akciğer nakil adaylarında yapılan bir çalışmada, 6-dakika yürüme mesafesinin mortalite ile bağımsız olarak korele olduğu ve bu mesafenin, beslenme belirteçlerinden olan vücut yağ kütlesi ve bacak kas kütlesinden etkilendiği ortaya konmuştur (17).…”

Section: Discussionunclassified

The Relationship of Exercise Capacity with Peripheral Muscle Strength and Lung Functıons in Lung Transplantion Candidates

Pehlivan¹,

Kalafat²,

Balcı³

et al. 2019

Mustafa Kemal Üniversitesi Tıp Dergisi

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Amaç: Çalışmamızda akciğer nakil adaylarında fonksiyonel egzersiz kapasitesi seviyesinin, periferik kas gücü ve solunum fonksiyonları ile olan ilişkisini incelemeyi amaçladık. Gereç ve Yöntem: Hastanemiz pulmoner rehabilitasyon merkezinde, akciğer nakli öncesi rehabilitasyon programına alınması için refere edilen 25 hasta çalışmaya dahil edildi. Hastalar 6-dakika yürüyüş testi yürüme mesafelerine (6DYM) göre 2 gruba ayrıldı (Grup1: 6DYM<350m, n:14; Grup2: 6DYM≥350m, n=11). Grupların kas ve yağ kütle ve yüzdeleri, periferik kas kuvvetleri karşılaştırıldı, egzersiz kapasitesi seviyesinin kas kütlesi ve solunum fonksiyonları ile olan ilişkisi incelendi. Bulgular: Gruplar benzer demografik özelliklere sahipti (yaş, beden kitle indeksi). Kas kütleleri (p=,956), yağsız doku yüzdeleri (p=,956), yağ kütleleri (p=,827) ve vücut yağ yüzdeleri (p=,701) benzerdi. Periferik kas kuvvetleri karşılaştırıldığında diz ekstansiyonu, dirsek fleksiyonu ve el kavrama kuvvetleri benzer olup, Grup1'in dorsifleksiyon kas kuvvetinin (p=,039) ve FEV1% (p=0,033) değerlerinin istatistiksel olarak daha düşük olduğu tespit edildi. 6DYM ile diğer sonuç ölçümleri arasında yapılan ilişki analizinde dirsek fleksiyonu (r=,483; p=,015), dorsifleksiyon (r=,518; p=,008) kas kuvveti ve FEV1% (r=,514; p=,009) ile orta, FVC% (r=,605; p=,001) ile ise yüksek seviyede korelasyon tespit edildi. Sonuç: Çalışmamızdaki akciğer nakil adayı olan hastaların egzersiz kapasiteleri, kas ve yağ kütlesinden bağımsız olup, kas kuvvetinden ve solunum fonksiyonlarından etkilenmektedir. Bu durum, bu hasta grubunda egzersiz kapasitesindeki azalmanın daha ziyade primer akciğer patolojisine bağlı olduğunu düşündürmektedir. Daha anlamlı sonuçların elde edilebilmesi için, rehabilitasyon sonrası değişimler incelenmelidir.

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“…Historically, the degree of airflow limitation has been used to select patients with COPD for pulmonary rehabilitation . However, just using the degree of lung function impairment is not enough to truly understand the physical, emotional and social conditions of adults with a chronic respiratory disease . Indeed, dyspnoea, fatigue, dynamic hyperinflation, a reduced physical capacity, an impaired disease‐specific health status and social deprivation already occur in patients with a mild degree of airflow limitation .…”

Section: Settings For Pulmonary Rehabilitationmentioning

confidence: 99%

“…For example, physiotherapists should be aware of the various treatment possibilities, including neuromuscular electrical stimulation and exercise training combined with non‐invasive ventilation; or dieticians should be trained to modulate patient's nutritional pattern, taking body composition abnormalities (i.e. cachexia and obesity) and cardiovascular risk factors (i.e. hypertension, hyperglycaemia and hyperlipidaemia) into consideration.…”

Section: Settings For Pulmonary Rehabilitationmentioning

confidence: 99%

Organizational aspects of pulmonary rehabilitation in chronic respiratory diseases

Spruit

Wouters

2019

Respirology

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Adult patients with chronic respiratory diseases may suffer from multiple physical (pulmonary and extrapulmonary), emotional and social features which necessitate a comprehensive, interdisciplinary rehabilitation programme. To date, pulmonary rehabilitation programmes show a lot of variation in setting, content, frequency and duration. Future projects should strive for a standard set of assessment measures to identify patients eligible for pulmonary rehabilitation, taking disease complexity into consideration, which should result in referral to an appropriate rehabilitation setting. Local circumstances may complicate this crucial endeavour.

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Clinical impact of body composition phenotypes in patients with COPD: a retrospective analysis

Cited by 23 publications

References 35 publications

Longitudinal changes in total and regional body composition in patients with chronic obstructive pulmonary disease

Longitudinal changes in total and regional body composition in patients with chronic obstructive pulmonary disease

The Relationship of Exercise Capacity with Peripheral Muscle Strength and Lung Functıons in Lung Transplantion Candidates

Organizational aspects of pulmonary rehabilitation in chronic respiratory diseases

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