Department of Respiratory Medicine, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center+, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Thorax. 2011 Nov;66(11):961-9. doi: 10.1136/thoraxjnl-2011-200010. Epub 2011 Jul 1.
and aims Cross-sectional studies suggest that obstructive lung disease (OLD) and smoking affect lean mass and mobility. A study was undertaken to investigate whether OLD and smoking accelerate the ageing-related decline in lean mass and physical functioning.
260 patients with OLD (mean±SD forced expiratory volume in 1 s (FEV1) 63±18% predicted), 157 smoking controls (FEV(1) 95±16% predicted), 866 former-smoking controls (FEV1 100±16% predicted) and 891 never-smoking controls (FEV1 104±17% predicted) participating in the Health, Aging and Body Composition (ABC) Study were studied. At baseline the mean age was 74±3 years and participants reported no functional limitations. Baseline and 7-year longitudinal data of body composition (by dual-energy x-ray absorptiometry), muscle strength (by hand and leg dynamometry) and Short Physical Performance Battery (SPPB) were investigated.
Compared with never-smoking controls, patients with OLD and smoking controls had a significantly lower weight, fat mass, lean mass and bone mineral content (BMC) at baseline (p<0.05). While the loss of weight, fat mass, lean mass and strength was comparable between patients with OLD and never-smoking controls, the SPPB declined 0.12 points/year faster in men with OLD (p=0.01) and BMC declined 4 g/year faster in women with OLD (p=0.02). In smoking controls only lean mass declined 0.1 kg/year faster in women (p=0.03) and BMC 8 g/year faster in men (p=0.02) compared with never-smoking controls.
Initially well-functioning older adults with mild-to-moderate OLD and smokers without OLD have a comparable compromised baseline profile of body composition and physical functioning, while 7-year longitudinal trajectories are to a large extent comparable to those observed in never-smokers without OLD. This suggests a common insult earlier in life related to smoking.
横断面研究表明，阻塞性肺疾病（OLD）和吸烟会影响瘦体重和活动能力。本研究旨在探讨 OLD 和吸烟是否会加速与衰老相关的瘦体重和身体机能下降。
共有 260 名 OLD 患者（平均用力呼气量第一秒（FEV1）占预计值的 63±18%）、157 名吸烟对照者（FEV1 占预计值的 95±16%）、866 名曾经吸烟对照者（FEV1 占预计值的 100±16%）和 891 名从不吸烟对照者（FEV1 占预计值的 104±17%）参与了健康、老龄化和身体成分（ABC）研究。基线时平均年龄为 74±3 岁，参与者无功能限制。研究了基线和 7 年的身体成分（双能 X 射线吸收法）、肌肉力量（手和腿部测力计）和短体物理表现电池（SPPB）的纵向数据。
与从不吸烟的对照者相比，OLD 患者和吸烟对照者的基线体重、体脂、瘦体重和骨矿物质含量（BMC）明显较低（p<0.05）。虽然 OLD 患者和从不吸烟的对照者之间的体重、体脂、瘦体重和力量损失相当，但 OLD 男性的 SPPB 每年下降 0.12 分（p=0.01），女性的 BMC 每年下降 4 克（p=0.02）。在吸烟对照者中，仅女性的瘦体重每年下降 0.1 公斤（p=0.03），男性的 BMC 每年下降 8 克（p=0.02），与从不吸烟的对照者相比更快。
最初功能良好的老年患者，轻度至中度 OLD 和没有 OLD 的吸烟者，在身体成分和身体功能方面具有相似的基线受损特征，而 7 年的纵向轨迹在很大程度上与没有 OLD 的不吸烟者相似。这表明生命早期存在与吸烟有关的共同损伤。
