身体组成和肌肉减少症对慢性阻塞性肺疾病患者死亡率的影响
Impact of Body Composition and Sarcopenia on Mortality in Chronic Obstructive Pulmonary Disease Patients.
作者信息
Gómez-Martínez Manuel, Rodríguez-García Wendy, González-Islas Dulce, Orea-Tejeda Arturo, Keirns-Davis Candace, Salgado-Fernández Fernanda, Hernández-López Samantha, Jiménez-Valentín Angelia, Ríos-Pereda Alejandra Vanessa, Márquez-Cordero Juan Carlos, Salvatierra-Escobar Mariana, López-Vásquez Iris
机构信息
Heart Failure and Respiratory Distress Clinic, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico City C.P. 14080, Mexico.
Licenciatura en Nutriología, Facultad de Estudios Superiores Zaragoza, Universidad Nacional Autónoma de México, Mexico City C.P. 09230, Mexico.
出版信息
J Clin Med. 2023 Feb 7;12(4):1321. doi: 10.3390/jcm12041321.
BACKGROUND
Patients with chronic obstructive pulmonary disease (COPD) have alterations in body composition, such as low cell integrity, body cell mass, and disturbances in water distribution evidenced by higher impedance ratio (IR), low phase angle (PhA), as well as low strength, low muscle mass, and sarcopenia. Body composition alterations are associated with adverse outcomes. However, according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), the impact of these alterations on mortality in COPD patients is not well-established. Our aims were to evaluate whether low strength, low muscle mass, and sarcopenia impacted mortality in COPD patients.
METHODS
A prospective cohort study performance was conducted with COPD patients. Patients with cancer, and asthma were excluded. Body composition was assessed by bioelectrical impedance analysis. Low strength and muscle mass, and sarcopenia were defined according to EWGSOP2.
RESULTS
240 patients were evaluated, of whom 32% had sarcopenia. The mean age was 72.32 ± 8.24 years. The factors associated with lower risk of mortality were handgrip strength (HR:0.91, CI 95%; 0.85 to 0.96, = 0.002), PhA (HR:0.59, CI 95%; 0.37 to 0.94, = 0.026) and exercise tolerance (HR:0.99, CI 95%; 0.992 to 0.999, = 0.021), while PhA below the 50th percentile (HR:3.47, CI 95%; 1.45 to 8.29, = 0.005), low muscle strength (HR:3.49, CI 95%; 1.41 to 8.64, = 0.007) and sarcopenia (HR:2.10, CI 95%; 1.02 to 4.33, = 0.022) were associated with a higher risk of mortality.
CONCLUSION
Low PhA, low muscle strength, and sarcopenia are independently associated with poor prognosis in COPD patients.
背景
慢性阻塞性肺疾病（COPD）患者存在身体成分改变，如细胞完整性降低、身体细胞质量减少以及水分布紊乱，表现为较高的阻抗比（IR）、低相位角（PhA），同时伴有力量减弱、肌肉量减少和肌肉减少症。身体成分改变与不良预后相关。然而，根据欧洲老年人肌肉减少症工作组2（EWGSOP2）的研究，这些改变对COPD患者死亡率的影响尚未明确。我们的目的是评估力量减弱、肌肉量减少和肌肉减少症是否会影响COPD患者的死亡率。
方法
对COPD患者进行前瞻性队列研究。排除患有癌症和哮喘的患者。通过生物电阻抗分析评估身体成分。根据EWGSOP2定义低力量、低肌肉量和肌肉减少症。
结果
共评估了240例患者，其中32%患有肌肉减少症。平均年龄为72.32±8.24岁。与较低死亡风险相关的因素包括握力（HR：0.91，95%CI：0.85至0.96，P = 0.002）、PhA（HR：0.59，95%CI：0.37至0.94，P = 0.026）和运动耐力（HR：0.99，95%CI：0.992至0.999，P = 0.021），而PhA低于第50百分位数（HR：3.47，95%CI：1.45至8.29，P = 0.005）、低肌肉力量（HR：3.49，95%CI：1.41至8.64，P = 0.007）和肌肉减少症（HR：2.10，95%CI：1.02至4.33，P = 0.022）与较高的死亡风险相关。
结论
低PhA、低肌肉力量和肌肉减少症与COPD患者的不良预后独立相关。
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