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American Journal of Clinical Nutrition, Vol. 71, No. 3, 733-738, March 2000
© 2000 American Society for Clinical Nutrition


Original Research Communications

Skeletal muscle weakness is associated with wasting of extremity fat-free mass but not with airflow obstruction in patients with chronic obstructive pulmonary disease1,2,3

Mariëlle PKJ Engelen, Annemie MWJ Schols, Joan D Does and Emiel FM Wouters

1 From the Department of Pulmonology, University Hospital Maastricht and the Asthma Centre Hornerheide, Horn, Netherlands.

Background: Skeletal muscle weakness is a prominent problem in many patients with chronic obstructive pulmonary disease (COPD).

Objective: The aim of the study was to determine the relation between skeletal muscle function, body composition, and lung function in COPD (emphysema and chronic bronchitis) patients and healthy volunteers.

Design: In 50 patients with chronic bronchitis, 49 patients with emphysema, and 28 healthy volunteers, skeletal muscle function was assessed by handgrip and linear isokinetic dynamometry. Whole-body and subregional fat-free mass (FFM) were assessed by dual-energy X-ray absorptiometry.

Results: Whole-body and extremity FFM were significantly lower in patients with emphysema (P < 0.001) and chronic bronchitis (P < 0.05) than in healthy volunteers, but trunk FFM was significantly lower only in patients with emphysema (P < 0.001). Extremity FFM was not significantly different between the COPD subtype groups, despite significantly lower values for whole-body and trunk FFM (P < 0.05) in patients with emphysema. Absolute skeletal muscle function (P < 0.001) and muscle function per kilogram of whole-body FFM were significantly lower in both COPD subtype groups than in healthy volunteers (P < 0.05), but no significant difference was found between patients with chronic bronchitis and those with emphysema. Muscle function per kilogram of extremity FFM was not significantly different between the 3 groups and was not associated with forced expiratory volume in 1 s.

Conclusion: Skeletal muscle weakness is associated with wasting of extremity FFM in COPD patients, independent of airflow obstruction and COPD subtype.

Key Words: Skeletal muscle weakness • extremity fat-free mass • chronic bronchitis • emphysema • chronic obstructive pulmonary disease • COPD • dual-energy X-ray absorptiometry • humans




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