Division of Respiratory Medicine, National Hospital Organization Fukuoka Hospital, Fukuoka, Japan.
Division of Psychosomatic Medicine, National Hospital Organization Fukuoka Hospital, Fukuoka, Japan.
PLoS One. 2022 Jul 27;17(7):e0270836. doi: 10.1371/journal.pone.0270836. eCollection 2022.
Physical activity, which can be affected by airflow limitation and extrapulmonary comorbidities, has been reported to be reduced in patients with chronic obstructive pulmonary disease, and reduced physical activity is associated with higher risks of exacerbation and mortality. The aim of the present study is to elucidate the comprehensive effect of extrapulmonary comorbidities on physical activity in Japanese patients with chronic obstructive pulmonary disease, of which evidence is lacking. We conducted a cross-sectional study with a series of tests, including lung function, physical activity, symptom scores, and parameters for comorbidities. Sixty outpatients with stable disease were enrolled, and the relationship between the parameters and physical activity was evaluated. Physical activity was assessed over 7 consecutive days using a triaxial accelerometer, which records total daily energy expenditure, step count, and walking time. Cardiovascular status was assessed via echocardiography, and pulmonary artery pressure was estimated using Doppler sonography. As to mental status, depression and anxiety were assessed using the Self-Rating Depression Scale and State-Trait Anxiety Inventory, respectively. Physical activity level was significantly correlated with step count, walking time, body mass index, lean body mass index, lung function, pulmonary artery pressure, depression, anxiety, and serum total cholesterol level. In a median regression model analysis, low lung function, low lean body mass index, depression, and low serum total cholesterol level were independently associated with decreased physical activity level. These findings suggest that physical inactivity is affected by multiple extrapulmonary factors, including skeletal muscle dysfunction, depressive symptoms, and nutritional state, in Japanese patients with chronic obstructive pulmonary disease.
体力活动可受到气流受限和肺外合并症的影响，有研究报道慢性阻塞性肺疾病患者的体力活动减少，而体力活动减少与加重和死亡风险增加相关。本研究旨在阐明肺外合并症对日本慢性阻塞性肺疾病患者体力活动的综合影响，目前这方面的证据有限。我们进行了一项横断面研究，包括一系列测试，包括肺功能、体力活动、症状评分和合并症参数。共纳入 60 例稳定期患者，并评估了这些参数与体力活动的关系。使用三轴加速度计在连续 7 天内评估体力活动，记录总日常能量消耗、步数和步行时间。通过超声心动图评估心血管状态，通过多普勒超声估计肺动脉压。至于精神状态，使用自评抑郁量表和状态特质焦虑量表分别评估抑郁和焦虑。体力活动水平与步数、步行时间、体重指数、瘦体重指数、肺功能、肺动脉压、抑郁、焦虑和血清总胆固醇水平显著相关。在中位数回归模型分析中，低肺功能、低瘦体重指数、抑郁和低血清总胆固醇水平与体力活动水平降低独立相关。这些发现表明，在日本慢性阻塞性肺疾病患者中，体力活动减少受到多种肺外因素的影响，包括骨骼肌功能障碍、抑郁症状和营养状态。
