title: Different patterns of chronic tissue wasting among patients with chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  Nutritional depletion is frequently present in patients with chronic obstructive pulmonary disease, but it is unknown whether a difference exists between the two subtypes. The aim of this study was to determine whether patterns of tissue depletion were different between emphysema and chronic bronchitis patients and whether these were related to pulmonary function.
  
  
  METHODS
  In 99 severe COPD patients and 28 healthy volunteers, body weight and composition were assessed by dual-energy X-ray absorptiometry. Patients were stratified into chronic bronchitis (n=50) and emphysema (n=49) by high-resolution computed tomography.
  
  
  RESULTS
  Lean mass depletion was found in 37% of the emphysema patients and in 12% of the chronic bronchitis patients. The emphysema patients had lower values for body mass index than the other groups (P< 0.01), mainly due to a lower lean mass (P< 0.01) and bone mineral content (P< 0.01). Fat mass was also lower in the emphysema group compared to the chronic bronchitis group (P< 0.001). The chronic bronchitis patients had a higher fat mass (P< 0.05) and a lower bone mineral content (P< 0.01) than the healthy volunteers.
  
  
  CONCLUSIONS
  Substantial differences in body composition were found not only between chronic obstructive pulmonary disease patients and healthy volunteers, but also between chronic bronchitis and emphysema patients.
authors.affiliation: Depts. of Pulmonology, University Hospital Maastricht, Horn, The Netherlands.
authors.forename: M P
authors.initials: MP
authors.lastname: Engelen
authors.forename: A M
authors.initials: AM
authors.lastname: Schols
authors.forename: R J
authors.initials: RJ
authors.lastname: Lamers
authors.forename: E F
authors.initials: EF
authors.lastname: Wouters
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D001823:Body Composition; D015992:Body Mass Index; D001835:Body Weight; D001991:Bronchitis / Q000145:classification / Q000503:physiopathology*; D016022:Case-Control Studies; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011656:Pulmonary Emphysema / Q000145:classification / Q000503:physiopathology*; D012016:Reference Values; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D019282:Wasting Syndrome / Q000378:metabolism / Q000503:physiopathology