<p>Body Composition of Filipino Chronic Obstructive Pulmonary Disease (COPD) Patients in Relation to Their Lung Function, Exercise Capacity and Quality of Life</p>

Abstract

Background and objectivesThe loss of muscle or fat free mass (FFM) as a result of systemic inflammation and poor nutrition in Chronic Obstructive Pulmonary Disease (COPD), is recognized as an important factor that influences symptoms and disease-related outcomes. To date, there are no data on body composition among Filipino COPD patients and how it impacts COPD disease severity. This paper examined the relationship of Fat Free Mass Index (FFMI = FFM/height) and sarcopenia with COPD disease severity variables.MethodsThis was a cross-sectional analytic study comparing low and normal FFMI, sarcopenic and nonsarcopenic COPD patients, in terms of lung function, exercise capacity, and quality of life score. Filipino COPD patients older than 40 years were included. Patients performed six minute walking distance (6MWD), handgrip strength (HGS), and quality of life status evaluation using Filipino version of COPD Assessment Test (CAT). Body composition was measured using bioelectrical impedance analysis (BIA).ResultsA total of 41 patients were included. The mean age was 69.22 years. The prevalence of being underweight and having sarcopenia was 32% and 46%, respectively. Point biserial correlation showed that COPD patients with low FFMI had a statistically significant reduction in peak inspiratory flow (r= −0.5791, P value 0.0002), peak expiratory flow (r= −0.4475, P value 0.0055), and handgrip strength (r= −0.4560, P value 0.0027); and lower CAT score (r= −0.3422, P value 0.0285). Similar findings were observed among sarcopenic COPD patients.ConclusionThe prevalence of being underweight and having sarcopenia was high. Low FFMI results in reduction of lung function and upper limb muscle strength among Filipino COPD patients.

Association of sarcopenia with osteoporosis in patients with chronic obstructive pulmonary disease

“…Forty-one adult Filipino COPD patients older than 40 years-old consulting at the Philippine General Hospital – outpatient pulmonary clinic consented and were included in this study. Clinico-demographic information, measurements for anthropometrics, body composition, lung function test, COPD assessment test (CAT) score, hand grip strength (HGS) and 6-min walk distance (6MWD) were recorded and performed (full protocol as seen on original study) [ 7 ]. Fat-free mass index (FFMI), appendicular lean muscle mass (ALM), and total body bone mineral density (BMD) were measured using whole body dual energy X-ray absorptiometry (DXA) scan (STRATOS DR, DMS-Imaging, Maugio, France).…”

“…Using the normative reference for Filipinos, we identified 46% of our COPD population to have sarcopenia [ 7 ]. This is higher than the reported prevalence of 21.6% (95% CI 14.6–30.9%, I 2 = 94%), among patients with COPD [ 13 ].…”

“…This is a post-hoc analysis of a study on body composition among Filipino COPD patients [7] . All procedures were reviewed and approved in compliance with the ethical standards of the University of the Philippines Manila-Research Ethics Board (Study code 2018-270).…”

“…[ 11 ] of < 12.50 kg/m 2 (male) and < 8.33 kg/m 2 (female), and low muscle strength defined as hand grip strength of < 24.54 kg (male) and < 16.10 kg (female). Prevalence of sarcopenia in this study population was based on the original study [ 7 ]. Using the lowest T-score of either lumbar spine (L1-L4) or total hip, we defined osteoporosis and osteopenia according to the World Health Organization (WHO) criteria [ 12 ] of T-score of > -1.0 as normal; -1.0 to -2.5 as osteopenia and < -2.5 as osteoporosis.…”

“…Just as in osteoporosis, older age, smaller waist circumference, smoking, and alcoholic beverage drinking were significant predictors of sarcopenia [ 6 ]. Sarcopenia has been identified in 46% of COPD patients, resulting in impaired pulmonary function and lower quality of life score [ 7 ]. Osteoporosis and sarcopenia have similar risk factors, and both contribute to higher risk of disabilities, falls, fractures and impaired physical mobility [ 8 ].…”