Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
Pulmonary Division, Cantonal Hospital of Muensterlingen, Muensterlingen, Switzerland.
COPD. 2020 Apr;17(2):150-155. doi: 10.1080/15412555.2020.1727428. Epub 2020 Feb 19.
Skeletal muscle dysfunction, functional exercise capacity impairment and reduced physical activity are characteristic features in patients with chronic obstructive pulmonary disease (COPD). Assessments addressing muscle strength of the upper limb, such as measurement of handgrip strength (HGS), are rarely performed and reported. We aimed to analyze the course of HGS and possible predictors of changes in HGS over time in COPD. Yearly assessments of various disease markers were performed for a follow-up of up to seven years in a cohort of COPD patients to assess the longitudinal disease process. Data of 194 patients with at least one follow-up measurement were analyzed. HGS decreased significantly by = -0.86 (95% CI -1.09/-0.62, < 0.001) over time. The multivariate mixed effects model showed an independent association between greater annual declines in HGS and lower numbers of steps per day by = 0.11 (95% CI 0.03/0.18, = 0.006) and an enhanced change in COPD Assessment Test scores by = -0.01 (95% CI -0.01/-0.00, = 0.034). No evidence for an independent association between annual decline in HGS and FEV% pred. by = -0.01 (95% CI -0.03/0.01, = 0.297) was shown. Patients who died during follow-up did not exhibit greater declines in HGS compared to survivors ( = 0.884). Although HGS significantly decreased over time, no pathophysiological link with COPD disease progression could be demonstrated. Previous cross-sectional associations between HGS and mortality could not be confirmed in this longitudinal setting. Our data suggests that repeated monitoring of HGS in clinical settings seems not to be helpful to predict COPD specific disease progression.
骨骼肌功能障碍、运动能力受损和体力活动减少是慢性阻塞性肺疾病(COPD)患者的特征。很少对上肢肌肉力量进行评估,例如握力(HGS)的测量。我们旨在分析 COPD 患者 HGS 的变化过程以及 HGS 随时间变化的可能预测因素。对 COPD 患者队列进行了长达七年的随访,每年评估各种疾病标志物,以评估纵向疾病过程。对至少有一次随访测量值的 194 名患者进行了数据分析。HGS 随时间呈显著下降趋势,= -0.86(95%CI -1.09/-0.62, < 0.001)。多变量混合效应模型显示,HGS 每年下降幅度与每天步数减少呈独立相关,= 0.11(95%CI 0.03/0.18, = 0.006),与 COPD 评估测试评分变化呈独立相关,= -0.01(95%CI -0.01/-0.00, = 0.034)。FEV% pred. 与 HGS 每年下降之间没有独立的关联,= -0.01(95%CI -0.03/0.01, = 0.297)。随访期间死亡的患者与存活患者相比,HGS 下降幅度没有更大,= 0.884。尽管 HGS 随时间显著下降,但未能证明与 COPD 疾病进展有病理生理联系。在这种纵向研究中,无法证实 HGS 与死亡率的先前横断面关联。我们的数据表明,在临床环境中重复监测 HGS 似乎无助于预测 COPD 特定疾病的进展。