title: Sarcopenic Obesity, Functional Outcomes, and Systemic Inflammation in Patients With Chronic Obstructive Pulmonary Disease.
abstract: Both loss of muscle mass (ie, sarcopenia) and obesity adversely impact clinically important outcomes in patients with chronic obstructive pulmonary disease (COPD). Currently, there are only a few studies in patients with COPD with sarcopenia and concurrent obesity, termed sarcopenic obesity (SO).
  
  
  
  To explore the effects of SO on exercise capacity, health status, and systemic inflammation in COPD.
  
  
  
  Baseline data collected from a total of 2548 participants (2000 patients with COPD, mean age (SD), 63.5 (7.1) years; and 548 controls, 54.8 (9.0) years) from ECLIPSE (Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints) study, a multicenter longitudinal observational study, were used.
  
  
  
  All participants were divided into 4 body composition phenotypes using bioelectrical impedance analysis: (1) normal body composition, (2) obesity, (3) sarcopenia, and (4) SO. In patients with COPD, the 6-minute walking distance, disease-specific health status, and plasma inflammatory markers were compared among the respective body composition groups.
  
  
  
  Patients with COPD were 3 times more likely to present with SO compared with controls without COPD (odds ratio [OR] 3.3, 95% confidence interval [CI] 2.0-5.4, P < .001). In patients with COPD, SO was related to reduced 6-minute walking distance (-28.0 m, 95% CI -45.6 to -10.4), P < .01) and to higher systemic inflammatory burden (an elevation of at least 2 inflammatory markers, OR 1.6, 95% CI 1.1-2.5, P = .028) compared with the normal body composition group after adjustments for age, sex, smoking, body mass index, and airflow limitation.
  
  
  
  Our findings suggest that SO is associated with worse physical performance and higher systemic inflammatory burden compared with other body composition phenotypes in patients with COPD.
  
  
  
  ClinicalTrials.gov no. NCT00292552.
authors.affiliation: Department of Respiratory Medicine, PJ Safarik University, Kosice, Slovakia; Department of Research and Education, CIRO, Horn, Netherlands. Electronic address: joppapavol@gmail.com.
authors.forename: Pavol
authors.initials: P
authors.lastname: Joppa
authors.affiliation: Department of Respiratory Medicine, PJ Safarik University, Kosice, Slovakia.
authors.forename: Ruzena
authors.initials: R
authors.lastname: Tkacova
authors.affiliation: Department of Research and Education, CIRO, Horn, Netherlands.
authors.forename: Frits M E
authors.initials: FM
authors.lastname: Franssen
authors.affiliation: Medical Nutrition Education, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE.
authors.forename: Corrine
authors.initials: C
authors.lastname: Hanson
authors.affiliation: Division of Pulmonary, Critical Care, Sleep and Allergy, University of Nebraska Medical Center, Omaha, NE; Clinical Discovery Unit, AstraZeneca, Cambridge, UK.
authors.forename: Stephen I
authors.initials: SI
authors.lastname: Rennard
authors.affiliation: Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
authors.forename: Edwin K
authors.initials: EK
authors.lastname: Silverman
authors.affiliation: Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
authors.forename: Merry-Lynn N
authors.initials: ML
authors.lastname: McDonald
authors.affiliation: Pulmonary and Rehabilitation Medicine, University of Liverpool, Liverpool, UK.
authors.forename: Peter M A
authors.initials: PM
authors.lastname: Calverley
authors.affiliation: GlaxoSmithKline, King of Prussia, PA.
authors.forename: Ruth
authors.initials: R
authors.lastname: Tal-Singer
authors.affiliation: Department of Research and Education, CIRO, Horn, Netherlands; REVAL-Rehabilitation Research Center, BIOMED-Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
authors.forename: Martijn A
authors.initials: MA
authors.lastname: Spruit
authors.affiliation: Department of Respiratory Medicine and Pulmonary Rehabilitation, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Kenn
authors.affiliation: Department of Research and Education, CIRO, Horn, Netherlands; Department of Respiratory Medicine, University of Maastricht, Maastricht, Netherlands.
authors.forename: Emiel F M
authors.initials: EF
authors.lastname: Wouters
authors.affiliation: Department of Research and Education, CIRO, Horn, Netherlands.
authors.forename: Erica P A
authors.initials: EP
authors.lastname: Rutten
mesh_terms: D000368:Aged; D015897:Comorbidity; D005260:Female; D006304:Health Status; D006801:Humans; D007249:Inflammation; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009765:Obesity; D064887:Observational Studies as Topic; D029424:Pulmonary Disease, Chronic Obstructive; D055948:Sarcopenia
keywords: 6-minute walking distance; Body composition; chronic obstructive pulmonary disease; fibrinogen; sarcopenic obesity; systemic inflammation