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

被引：78

作者：

Joppa, Pavol ^{[1
,2
]}

Tkacova, Ruzena ^{[1
]}

Franssen, Frits M. E. ^{[2
]}

Hanson, Corrine ^{[3
]}

Rennard, Stephen I. ^{[4
,5
]}

Silverman, Edwin K. ^{[6
,7
]}

McDonald, Merry-Lynn N. ^{[6
]}

Calverley, Peter M. A. ^{[8
]}

Tal-Singer, Ruth ^{[9
]}

Spruit, Martijn A. ^{[2
,10
]}

Kenn, Klaus ^{[11
]}

Wouters, Emiel F. M. ^{[2
,12
]}

Rutten, Erica P. A. ^{[2
]}

机构：

[1] Safarik Univ, Dept Resp Med, Kosice, Slovakia

[2] CIRO, Dept Res & Educ, Horn, Netherlands

[3] Univ Nebraska Med Ctr, Coll Allied Hlth Profess, Med Nutr Educ, Omaha, NE USA

[4] Univ Nebraska Med Ctr, Div Pulm Crit Care Sleep & Allergy, Omaha, NE USA

[5] AstraZeneca, Clin Discovery Unit, Cambridge, England

[6] Harvard Med Sch, Brigham & Womens Hosp, Channing Div Network Med, Boston, MA USA

[7] Harvard Med Sch, Brigham & Womens Hosp, Div Pulm & Crit Care Med, Boston, MA USA

[8] Univ Liverpool, Pulm & Rehabil Med, Liverpool, Merseyside, England

[9] GlaxoSmithKline, King Of Prussia, PA USA

[10] Hasselt Univ, Fac Med & Life Sci, BIOMED Biomed Res Inst, REVAL Rehabil Res Ctr, Diepenbeek, Belgium

[11] Schoen Klin Berchtesgadener Land, Dept Resp Med & Pulm Rehabil, Schoenau, Germany

[12] Maastricht Univ, Dept Resp Med, Maastricht, Netherlands

来源：

JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION | 2016年 / 17卷 / 08期

关键词：

Body composition; sarcopenic obesity; chronic obstructive pulmonary disease; 6-minute walking distance; fibrinogen; systemic inflammation; QUALITY-OF-LIFE; BODY-COMPOSITION; CARDIOVASCULAR-DISEASE; RISK-FACTORS; FAT MASS; COPD; MORTALITY; HEALTH; ASSOCIATION; PERFORMANCE;

D O I：

10.1016/j.jamda.2016.03.020

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

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.

引用

页码：712 / 718

页数：7

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