Journal
THORAX
Volume 70, Issue 3, Pages 213-218Publisher
BMJ PUBLISHING GROUP
DOI: 10.1136/thoraxjnl-2014-206440
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Funding
- NIHR Respiratory Biomedical Research Unit at the Royal Brompton and Harefield NHS Foundation Trust and Imperial College London
- National Institute for Health Research (NIHR) Post-Doctoral and a Clinical Trials Fellowship
- Medical Research Council
- NIHR Doctoral Fellowship
- National Institute for Health Research Clinician Scientist Award [CS/7/007]
- Medical Research Council (UK) New Investigator Research Grant [G1002113]
- National Institute for Health Research Clinical Trials Fellowship [NIHR-CTF-01-12-04]
- MRC [G1002113] Funding Source: UKRI
- Medical Research Council [G1002113] Funding Source: researchfish
- National Institute for Health Research [PDF-2011-04-048, NIHR-CTF-2013-02-009] Funding Source: researchfish
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Background Age-related loss of muscle, sarcopenia, is recognised as a clinical syndrome with multiple contributing factors. International European Working Group on Sarcopenia in Older People (EWGSOP) criteria require generalised loss of muscle mass and reduced function to diagnose sarcopenia. Both are common in COPD but are usually studied in isolation and in the lower limbs. Objectives To determine the prevalence of sarcopenia in COPD, its impact on function and health status, its relationship with quadriceps strength and its response to pulmonary rehabilitation (PR). Methods EWGSOP criteria were applied to 622 outpatients with stable COPD. Body composition, exercise capacity, functional performance, physical activity and health status were assessed. Using a case-control design, response to PR was determined in 43 patients with sarcopenia and a propensity score-matched non-sarcopenic group. Results Prevalence of sarcopenia was 14.5% (95% CI 11.8% to 17.4%), which increased with age and Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) stage, but did not differ by gender or the presence of quadriceps weakness (14.9 vs 13.8%, p=0.40). Patients with sarcopenia had reduced exercise capacity, functional performance, physical activity and health status compared with patients without sarcopenia (p<0.001), but responded similarly following PR; 12/43 patients were no longer classified as sarcopenic following PR. Conclusions Sarcopenia affects 15% of patients with stable COPD and impairs function and health status. Sarcopenia does not impact on response to PR, which can lead to a reversal of the syndrome in select patients.
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