Changes in body composition in patients with chronic obstructive pulmonary disease: do they influence patient-related outcomes?
OBJECTIVE
The follow-up of the ECLIPSE study, a prospective longitudinal study to identify and define parameters that predict disease progression over 3 years in chronic obstructive pulmonary disease (COPD), allows the examination of the effect of body composition changes on COPD-related outcomes.


METHODS
Body composition and health status were established in 2,115 COPD patients, 327 smoking and 239 nonsmoking controls at baseline and 3 years, while mortality was recorded in year 2 and 3 in the COPD patients. Associations between fat free mass index (FFMI) and fat mass index (FMI) changes to deterioration in health status and mortality were determined.


RESULTS
Change in FFMI and FMI over 3 years was small and comparable between the groups. Underweight and obese patients had the worst health status. Worsening health status was associated with FFMI decrease in underweight patients and FMI increase in overweight/obese patients. While overweight patients had the lowest mortality, FFMI or FMI decrease was associated with a higher mortality.


CONCLUSIONS
Changes in body composition over 3 years were small and comparable in COPD patients and control subjects. Nevertheless, muscle mass decline in underweight and fat mass increase in overweight/obese patients is associated with worsening health status. Overweight is associated with decreased mortality, but muscle mass and fat mass decline are detrimental for mortality.
Center of Expertise for Chronic Organ Failure (Ciro+), Horn, The Netherlands.
Erica P A
EP
Rutten
Peter M A
PM
Calverley
Richard
R
Casaburi
Alvar
A
Agusti
Per
P
Bakke
Bartolome
B
Celli
Harvey O
HO
Coxson
Courtney
C
Crim
David A
DA
Lomas
William
W
Macnee
Bruce E
BE
Miller
Stephan I
SI
Rennard
Paul D
PD
Scanlon
Edwin K
EK
Silverman
Ruth
R
Tal-Singer
Jørgen
J
Vestbo
Michael L
ML
Watkins
Emiel F M
EF
Wouters
D000273:Adipose Tissue; D000368:Aged; D001823:Body Composition; D001835:Body Weight; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D013851:Thinness / Q000503:physiopathology