| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
ORIGINAL RESEARCH COMMUNICATION |
1 From the Department of Respiratory Medicine, University of Maastricht, Maastricht, Netherlands (AMWJS, RB, and EFW) and the Asthma Centre Hornerheide, Horn, Netherlands (CAW)
Background: Survival studies have consistently shown significantly greater mortality rates in underweight and normal-weight patients with chronic obstructive pulmonary disease (COPD) than in overweight and obese COPD patients.
Objective: To compare the contributions of low fat-free mass and low fat mass to mortality, we assessed the association between body composition and mortality in COPD.
Design: We studied 412 patients with moderate-to-severe COPD [Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) stages II–IV, forced expiratory volume in 1 s of 36 ± 14% of predicted (range: 19–70%). Body composition was assessed by using single-frequency bioelectrical impedance. Body mass index, fat-free mass index, fat mass index, and skeletal muscle index were calculated and related to recently developed reference values. COPD patients were stratified into defined categories of tissue-depletion pattern. Overall mortality was assessed at the end of follow-up.
Results: Semistarvation and muscle atrophy were equally distributed among disease stages, but the highest prevalence of cachexia was seen in GOLD stage IV. Forty-six percent of the patients (n = 189) died during a maximum follow-up of 5 y. Cox regression models, with and without adjustment for disease severity, showed that fat-free mass index (relative risk: 0.90; 95% CI: 0.84, 0.96; P = 0.003) was an independent predictor of survival, but fat mass index was not. Kaplan-Meier and Cox regression plots for cachexia and muscle atrophy did not differ significantly.
Conclusions: Fat-free mass is an independent predictor of mortality irrespective of fat mass. This study supports the inclusion of body-composition assessment as a systemic marker of disease severity in COPD staging.
Key Words: Mortality • chronic obstructive pulmonary disease • COPD • body composition • muscle mass • lung function
This article has been cited by other articles:
|
|
 |
|
  L. Graat-Verboom, E. F. M. Wouters, F. W. J. M. Smeenk, B. E. E. M. van den Borne, R. Lunde, and M. A. Spruit Current status of research on osteoporosis in COPD: a systematic review Eur. Respir. J., July 1, 2009; 34(1): 209 - 218. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M. W. J. Schols Nutritional rehabilitation: from pulmonary cachexia to sarcoPD Eur. Respir. J., May 1, 2009; 33(5): 949 - 950. [Full Text] [PDF]
|
|
|
|
 |
|
 C. Bolton, M. Stone, P. Edwards, J. Duckers, W. Evans, and D. Shale Circulating matrix metalloproteinase-9 and osteoporosis in patients with chronic obstructive pulmonary disease Chronic Respiratory Disease, May 1, 2009; 6(2): 81 - 87. [Abstract] [PDF]
|
|
|
|
 |
|
 E Barreiro, R Rabinovich, J Marin-Corral, J A Barbera, J Gea, and J Roca Chronic endurance exercise induces quadriceps nitrosative stress in patients with severe COPD Thorax, January 1, 2009; 64(1): 13 - 19. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. M. E. Franssen, H. P. Sauerwein, E. P. A. Rutten, E. F. M. Wouters, and A. M. W. J. Schols Whole-body resting and exercise-induced lipolysis in sarcopaenic patients with COPD Eur. Respir. J., December 1, 2008; 32(6): 1466 - 1471. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F M E Franssen, D E O'Donnell, G H Goossens, E E Blaak, and A M W J Schols Obesity and the lung: 5 {middle dot} Obesity and COPD Thorax, December 1, 2008; 63(12): 1110 - 1117. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Sauvaget, K. Ramadas, G. Thomas, J. Vinoda, S. Thara, and R. Sankaranarayanan Body mass index, weight change and mortality risk in a prospective study in India Int. J. Epidemiol., October 1, 2008; 37(5): 990 - 1004. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. A. King, F. Cordova, and S. M. Scharf Nutritional Aspects of Chronic Obstructive Pulmonary Disease Proceedings of the ATS, May 1, 2008; 5(4): 519 - 523. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. D. Wagner Possible mechanisms underlying the development of cachexia in COPD Eur. Respir. J., March 1, 2008; 31(3): 492 - 501. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Cazzola, W. MacNee, F. J. Martinez, K. F. Rabe, L. G. Franciosi, P. J. Barnes, V. Brusasco, P. S. Burge, P. M. A. Calverley, B. R. Celli, et al. Outcomes for COPD pharmacological trials: from lung function to biomarkers Eur. Respir. J., February 1, 2008; 31(2): 416 - 469. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Poulain, M. Doucet, V. Drapeau, G. Fournier, A. Tremblay, P. Poirier, and F. Maltais Metabolic and inflammatory profile in obese patients with chronic obstructive pulmonary disease Chronic Respiratory Disease, February 1, 2008; 5(1): 35 - 41. [Abstract] [PDF]
|
|
|
|
 |
|
 J. L. J. van der Velden, A. M. W. J. Schols, J. Willems, M. C. J. M. Kelders, and R. C. J. Langen Glycogen Synthase Kinase 3 Suppresses Myogenic Differentiation through Negative Regulation of NFATc3 J. Biol. Chem., January 4, 2008; 283(1): 358 - 366. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. P. Haranath, B. S. Park, M. Osborne, S. Budweiser, and R. A. Jorres Body Mass Index in COPD Mortality: Is It All in the Water? Chest, January 1, 2008; 133(1): 318 - 319. [Full Text] [PDF]
|
|
|
|
|
|
H. R Gosker, M. P Zeegers, E. F M Wouters, and A. M W J Schols Muscle fibre type shifting in the vastus lateralis of patients with COPD is associated with disease severity: a systematic review and meta-analysis Thorax, November 1, 2007; 62(11): 944 - 949. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Agusti Systemic Effects of Chronic Obstructive Pulmonary Disease: What We Know and What We Don't Know (but Should) Proceedings of the ATS, October 1, 2007; 4(7): 522 - 525. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Varraso, T. T Fung, R G. Barr, F. B Hu, W. Willett, and C. A Camargo Jr Prospective study of dietary patterns and chronic obstructive pulmonary disease among US women Am. J. Clinical Nutrition, August 1, 2007; 86(2): 488 - 495. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Doucet, A. P. Russell, B. Leger, R. Debigare, D. R. Joanisse, M.-A. Caron, P. LeBlanc, and F. Maltais Muscle Atrophy and Hypertrophy Signaling in Patients with Chronic Obstructive Pulmonary Disease Am. J. Respir. Crit. Care Med., August 1, 2007; 176(3): 261 - 269. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Ischaki, G. Papatheodorou, E. Gaki, I. Papa, N. Koulouris, and S. Loukides Body Mass and Fat-Free Mass Indices in COPD: Relation With Variables Expressing Disease Severity Chest, July 1, 2007; 132(1): 164 - 169. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. van den Bemt, T. Schermer, and C. van Weel Rational monitoring of COPD: where do current clinical guidelines stand? Eur. Respir. J., June 1, 2007; 29(6): 1078 - 1081. [Full Text] [PDF]
|
|
|
|
|
|
E. F. M. Wouters Decision Making in Chronic Hypercapnic Respiratory Failure: A Real Challenge! Chest, June 1, 2007; 131(6): 1622 - 1624. [Full Text] [PDF]
|
|
|
|
|
|
S. Budweiser, R. A. Jorres, T. Riedl, F. Heinemann, A. P. Hitzl, W. Windisch, and M. Pfeifer Predictors of Survival in COPD Patients With Chronic Hypercapnic Respiratory Failure Receiving Noninvasive Home Ventilation Chest, June 1, 2007; 131(6): 1650 - 1658. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. C Steiner Sarcopaenia in chronic obstructive pulmonary disease Thorax, February 1, 2007; 62(2): 101 - 103. [Full Text] [PDF]
|
|
|
|
|
|
C. E Bolton, R. Broekhuizen, A. A Ionescu, L. S Nixon, E. F M Wouters, D. J Shale, and A. M W J Schols Cellular protein breakdown and systemic inflammation are unaffected by pulmonary rehabilitation in COPD Thorax, February 1, 2007; 62(2): 109 - 114. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. B Swallow, D. Reyes, N. S Hopkinson, W. D-C Man, R. Porcher, E. J Cetti, A. J Moore, J. Moxham, and M. I Polkey Quadriceps strength predicts mortality in patients with moderate to severe chronic obstructive pulmonary disease Thorax, February 1, 2007; 62(2): 115 - 120. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. M. Schooling, T. H. Lam, Z. B. Li, S. Y. Ho, W. M. Chan, K. S. Ho, M. K. Tham, B. J. Cowling, and G. M. Leung Obesity, physical activity, and mortality in a prospective chinese elderly cohort. Arch Intern Med, July 24, 2006; 166(14): 1498 - 1504. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. M. Fabbri, F. Luppi, B. Beghe, and K. F. Rabe Update in chronic obstructive pulmonary disease 2005. Am. J. Respir. Crit. Care Med., May 15, 2006; 173(10): 1056 - 1065. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Poulain, M. Doucet, G. C. Major, V. Drapeau, F. Series, L.-P. Boulet, A. Tremblay, and F. Maltais The effect of obesity on chronic respiratory diseases: pathophysiology and therapeutic strategies. Can. Med. Assoc. J., April 25, 2006; 174(9): 1293 - 1299. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Marti, X. Munoz, J. Rios, F. Morell, and J. Ferrer Body weight and comorbidity predict mortality in COPD patients treated with oxygen therapy. Eur. Respir. J., April 1, 2006; 27(4): 689 - 696. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. P. Rutten, F. M. Franssen, M. P. Engelen, E. F. Wouters, N. E. Deutz, and A. M. Schols Greater whole-body myofibrillar protein breakdown in cachectic patients with chronic obstructive pulmonary disease. Am. J. Clinical Nutrition, April 1, 2006; 83(4): 829 - 834. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. S Hopkinson, K. I Eleftheriou, J. Payne, A. H Nickol, E. Hawe, J. Moxham, H. Montgomery, and M. I Polkey +9/+9 Homozygosity of the bradykinin receptor gene polymorphism is associated with reduced fat-free mass in chronic obstructive pulmonary disease. Am. J. Clinical Nutrition, April 1, 2006; 83(4): 912 - 917. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. F. M. Wouters Muscle Wasting in Chronic Obstructive Pulmonary Disease: To Bother and to Measure! Am. J. Respir. Crit. Care Med., January 1, 2006; 173(1): 4 - 5. [Full Text] [PDF]
|
|
|
|
|
|
D D Sin and S F P Man Skeletal muscle weakness, reduced exercise tolerance, and COPD: is systemic inflammation the missing link? Thorax, January 1, 2006; 61(1): 1 - 3. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
