title: Sarcopenia in COPD: relationship with COPD severity and prognosis.
abstract: OBJECTIVE
  To evaluate the prevalence of sarcopenia in COPD patients, as well as to determine whether sarcopenia correlates with the severity and prognosis of COPD.
  
  
  METHODS
  A cross-sectional study with COPD patients followed at the pulmonary outpatient clinic of our institution. The patients underwent dual-energy X-ray absorptiometry. The diagnosis of sarcopenia was made on the basis of the skeletal muscle index, defined as appendicular lean mass/height2 only for low-weight subjects and adjusted for fat mass in normal/overweight subjects. Disease severity (COPD stage) was evaluated with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. The degree of obstruction and prognosis were determined by the Body mass index, airflow Obstruction, Dyspnea, and Exercise capacity (BODE) index.
  
  
  RESULTS
  We recruited 91 patients (50 females), with a mean age of 67.4 ± 8.7 years and a mean BMI of 25.8 ± 6.1 kg/m2. Sarcopenia was observed in 36 (39.6%) of the patients, with no differences related to gender, age, or smoking status. Sarcopenia was not associated with the GOLD stage or with FEV1 (used as an indicator of the degree of obstruction). The BMI, percentage of body fat, and total lean mass were lower in the patients with sarcopenia than in those without (p < 0.001). Sarcopenia was more prevalent among the patients in BODE quartile 3 or 4 than among those in BODE quartile 1 or 2 (p = 0.009). The multivariate analysis showed that the BODE quartile was significantly associated with sarcopenia, regardless of age, gender, smoking status, and GOLD stage.
  
  
  CONCLUSIONS
  In COPD patients, sarcopenia appears to be associated with unfavorable changes in body composition and with a poor prognosis.
authors.affiliation: Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brasil.
authors.forename: Tatiana Munhoz da Rocha Lemos
authors.initials: TM
authors.lastname: Costa
authors.affiliation: Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brasil.
authors.forename: Fabio Marcelo
authors.initials: FM
authors.lastname: Costa
authors.affiliation: Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brasil.
authors.forename: Carolina Aguiar
authors.initials: CA
authors.lastname: Moreira
authors.affiliation: Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brasil.
authors.forename: Leda Maria
authors.initials: LM
authors.lastname: Rabelo
authors.affiliation: Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brasil.
authors.forename: César Luiz
authors.initials: CL
authors.lastname: Boguszewski
authors.affiliation: Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brasil.
authors.forename: Victória Zeghbi Cochenski
authors.initials: VZ
authors.lastname: Borba
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D015992:Body Mass Index; D001938:Brazil / Q000453:epidemiology; D004417:Dyspnea / Q000503:physiopathology; D004812:Epidemiologic Methods; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology*; D055948:Sarcopenia / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology*; D012720:Severity of Illness Index