Takenaka H, Yoneda T, Fu Y A, Kobayashi A, Ikuno M, Tsukaguchi K, Okamoto Y, Yamamoto C, Narita N
Second Department of Internal Medicine, Nara Medical University, Japan.
Nihon Kokyuki Gakkai Zasshi. 1998 Aug;36(8):653-8.
In this study we utilized bioelectrical impedance analysis (BIA) to compare the body composition of 36 stable pulmonary emphysema (PE) patients with 19 healthy controls. We compared the PE patients and healthy controls in terms of fat-free mass (FFM) and body fat (BF) as percentages of ideal body weight (FFM/IBW, BF/IBW). FFM/IBW and BF/IBW were significantly lower in the PE patients than in the controls (75.0 +/- 9.8% vs. 85.2 +/- 7.3%, p < 0.001 and 11.8 +/- 6.4% vs. 16.7 +/- 7.7%, p < 0.05, respectively). We divided the PE patients into two subgroups according to FFM, then investigated the relationships between FFM and skeletal muscle strength, and between FFM and respiratory muscle strength. In patients with reduced FFM (FFM < 43.5 kg) grip strength as an index of skeletal muscle strength was significantly lower than in patients without reduced FFM (FFM > or = 43.5 kg) (25.7 +/- 7.8 kg vs. 36.2 +/- 7.2 kg, p < 0.005). As indexes of respiratory muscle strength, maximal expiratory pressure (PEmax) and maximal inspiratory pressure (PImax) were lower in the patients with reduced of FFM, but not to a statistically significant degree (49.6 +/- 20.8 cm H2O vs. 58.7 +/- 23.9 cm H2O and 40.5 +/- 19.2 cm H2O vs. 50.2 +/- 22.1 cm H2O, respectively). In the PE patients, FFM correlated closely with vital capacity (r = 0.528, p < 0.001), forced vital capacity (FVC) (r = 0.531, p < 0.001), FEV1.0 (r = 0.554, p < 0.001), FEV1.0/FVC (r = 0.467, p < 0.005), RV/TLC (r = -0.395, p < 0.05), DLco (r = 0.770, p < 0.001), and DLco/VA (r = 0.622, p < 0.001). However no correlation was observed between BF and any of the measures of lung function. The findings of our study suggest that FFM correlates with skeletal muscle strength, respiratory muscle strength and some measures of lung function in patients with PE, and that assessments of body composition are valuable to their clinical management.
在本研究中，我们利用生物电阻抗分析（BIA）比较了36例稳定期肺气肿（PE）患者与19例健康对照者的身体组成。我们比较了PE患者和健康对照者的去脂体重（FFM）和体脂（BF）占理想体重的百分比（FFM/IBW，BF/IBW）。PE患者的FFM/IBW和BF/IBW显著低于对照组（分别为75.0±9.8%对85.2±7.3%，p<0.001；11.8±6.4%对16.7±7.7%，p<0.05）。我们根据FFM将PE患者分为两个亚组，然后研究FFM与骨骼肌力量之间以及FFM与呼吸肌力量之间的关系。在FFM降低的患者（FFM<43.5kg）中，作为骨骼肌力量指标的握力显著低于FFM未降低的患者（FFM≥43.5kg）（25.7±7.8kg对36.2±7.2kg，p<0.005）。作为呼吸肌力量指标，FFM降低的患者的最大呼气压力（PEmax）和最大吸气压力（PImax）较低，但未达到统计学显著程度（分别为49.6±20.8cmH₂O对58.7±23.9cmH₂O和40.5±19.2cmH₂O对50.2±22.1cmH₂O）。在PE患者中，FFM与肺活量（r=0.528，p<0.001）、用力肺活量（FVC）（r=0.531，p<0.001）、FEV₁.₀（r=0.554，p<0.001）、FEV₁.₀/FVC（r=0.467，p<0.005）、RV/TLC（r=-0.395，p<0.05）、DLco（r=0.770，p<0.001）和DLco/VA（r=0.622，p<0.001）密切相关。然而，未观察到BF与任何肺功能指标之间存在相关性。我们的研究结果表明，FFM与PE患者的骨骼肌力量、呼吸肌力量和一些肺功能指标相关，并且身体组成评估对其临床管理具有重要价值。
