Sarcopenia in Advanced COPD Affects Cardiometabolic Risk Reduction by Short-Term High-intensity Pulmonary Rehabilitation.

Nanca Cebron Lipovec, Annemie M W J Schols, Bram van den Borst, Rosanne J H C G Beijers, Tatjana Kosten, Daniel Omersa, Mitja Lainscak

Journal: Journal of the American Medical Directors Association 2017;17(9):814-20

PMID: 27321867

Full Text on Elsevier Science View on PubMed

Abstract

OBJECTIVES

Sarcopenia is common in chronic obstructive pulmonary disease (COPD) and may contribute to increased cardiometabolic risk. Interventions to reduce cardiometabolic risk in advanced COPD have been scarcely studied. We have investigated the cardiometabolic effect of a short-term high-intensity rehabilitation program in sarcopenic and nonsarcopenic patients with advanced COPD.

DESIGN

Prospective observational study.

SETTING

Inpatient 4-week short-term high-intensity pulmonary rehabilitation program at the University Clinic Golnik, Slovenia.

PARTICIPANTS

112 stable COPD patients (66 ± 8 years, 85% GOLD III/IV, 66% men).

MEASUREMENTS

Blood biomarkers were assessed at baseline and after rehabilitation. Sarcopenia was assessed at baseline (skeletal muscle index <7.23 kg/m(2) for men and <5.67 kg/m(2) for women, as measured by whole-body dual energy X-ray absorptiometry. Insulin resistance (IR) was defined as homeostasis model assessment of insulin resistance (HOMA-IR) above 2.5.

RESULTS

IR and sarcopenia were detected in 59% and 55% of patients, respectively. In contrast to sarcopenic patients, rehabilitation decreased HOMA-IR (2.8 to 1.9, P = .031), fat mass index (10.1 to 9.7 kg/m(2), P = .013), waist circumference (103 to 101 cm, P = .002), and low-density lipoprotein cholesterol (3.2 to 3.0 mmol/L, P = .034) in nonsarcopenic patients. A decrease in total cholesterol levels was observed in both groups.

CONCLUSIONS

Sarcopenia affects the modification of cardiometabolic risk markers by short-term high-intensity pulmonary rehabilitation in advanced COPD patients.

Address: University Clinic of Pulmonary and Allergic Diseases Golnik, Golnik, Slovenia; NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands.; NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands.; University Clinic of Pulmonary and Allergic Diseases Golnik, Golnik, Slovenia.; National Institute of Public Health, Ljubljana, Slovenia.; Department of Cardiology and Department of Research and Education, General Hospital, Celje, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia. Electronic address: [email protected].

DOI: 10.1016/j.jamda.2016.05.002

Link outs

Free resources

Medical:

https://medlineplus.gov/copd.html

Other Literature Sources:

https://scite.ai/reports/27321867

Subscription / membership required

Full Text Sources:

MeSH Terms: Aged, Female, Humans, Lung, Male, Middle Aged, Prospective Studies, Pulmonary Disease, Chronic Obstructive, Risk Reduction Behavior, Sarcopenia, Severity of Illness Index, Slovenia