Body composition and resting energy expenditure in clinically stable, non-weight-losing patients with severe emphysema.
OBJECTIVE
To characterize the metabolic status of weight-stable and clinically stable individuals with advanced emphysema.


METHODS
Seventy-nine patients with severe emphysema (FEV(1), 29 +/- 13% of predicted [mean +/- SD]) evaluated for enrollment in the National Emphysema Treatment Trial and 20 age-matched healthy subjects were studied.


METHODS
Pulmonary function laboratory of university-affiliated teaching hospital.


METHODS
Data collection.


RESULTS
We measured lung function, body composition, serum leptin levels, serum tumor necrosis factor receptors (sTNF-Rs), resting oxygen consumption (RVO(2)) normalized to weight in kilograms (RVO(2)/kg), and RVO(2) normalized to fat-free mass (FFM) [RVO(2)/FFM]. The patient group and healthy group had similar age, body mass index (BMI), and body composition. RVO(2)/kg, RVO(2)/FFM, and sTNF-R levels were higher in patients compared to healthy subjects. There were no differences in serum leptin levels between emphysematous and healthy subjects, and there was no correlation between leptin and sTNF-R and RVO(2)/kg. Furthermore, both groups had similar gender-related differences in FFM, percentage of body fat, and serum leptin levels. Patients with lower BMI showed the greatest differences from control subjects in RVO(2)/kg.


CONCLUSIONS
In weight-stable subjects with advanced emphysema, RVO(2)/kg and RVO(2)/FFM were higher compared to healthy subjects, especially in those with BMI in the lower end of the normal range. RVO(2)/kg and RVO(2)/FFM did not correlate with leptin or sTNF-R levels. These data show that a higher metabolic rate is found in patients with emphysema who are clinically and weight stable. Thus, hypermetabolism is a feature of the disease and not sufficient to lead to weight loss.
Cohen
Rubin I
RI
Division of Pulmonary and Critical Care Medicine, The Long Island Jewish Medical Center, The Long Island Campus for The Albert Einstein College of Medicine, New Hyde Park, NY 11040, USA. rcohen@lij.edu
Marzouk
Kamel
K
Berkoski
Patricia
P
O'Donnell
Chris P
CP
Polotsky
Vsevolady Y
VY
Scharf
Steven M
SM
D000368:Aged; D001823:Body Composition; D015992:Body Mass Index; D004646:Emphysema / Q000378:metabolism* / Q000503:physiopathology; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D008297:Male; D010101:Oxygen Consumption; D012146:Rest; D012720:Severity of Illness Index; D012737:Sex Factors