Sarcopenia in Advanced COPD Affects Cardiometabolic Risk Reduction by Short-Term High-intensity Pulmonary Rehabilitation.
OBJECTIVES
Sarcopenia is common in chronic obstructive pulmonary disease (COPD) and may contribute to increased cardiometabolic risk. Interventions to reduce cardiometabolic risk in advanced COPD have been scarcely studied. We have investigated the cardiometabolic effect of a short-term high-intensity rehabilitation program in sarcopenic and nonsarcopenic patients with advanced COPD.


DESIGN
Prospective observational study.


SETTING
Inpatient 4-week short-term high-intensity pulmonary rehabilitation program at the University Clinic Golnik, Slovenia.


PARTICIPANTS
112 stable COPD patients (66 ± 8 years, 85% GOLD III/IV, 66% men).


MEASUREMENTS
Blood biomarkers were assessed at baseline and after rehabilitation. Sarcopenia was assessed at baseline (skeletal muscle index <7.23 kg/m(2) for men and <5.67 kg/m(2) for women, as measured by whole-body dual energy X-ray absorptiometry. Insulin resistance (IR) was defined as homeostasis model assessment of insulin resistance (HOMA-IR) above 2.5.


RESULTS
IR and sarcopenia were detected in 59% and 55% of patients, respectively. In contrast to sarcopenic patients, rehabilitation decreased HOMA-IR (2.8 to 1.9, P = .031), fat mass index (10.1 to 9.7 kg/m(2), P = .013), waist circumference (103 to 101 cm, P = .002), and low-density lipoprotein cholesterol (3.2 to 3.0 mmol/L, P = .034) in nonsarcopenic patients. A decrease in total cholesterol levels was observed in both groups.


CONCLUSIONS
Sarcopenia affects the modification of cardiometabolic risk markers by short-term high-intensity pulmonary rehabilitation in advanced COPD patients.
['Cebron Lipovec|Nanca|N|', 'Schols|Annemie M W J|AM|', 'van den Borst|Bram|B|', 'Beijers|Rosanne J H C G|RJ|', 'Kosten|Tatjana|T|', 'Omersa|Daniel|D|', 'Lainscak|Mitja|M|']
D000368:Aged D005260:Female D006801:Humans D008168:Lung D008297:Male D008875:Middle Aged D011446:Prospective Studies D029424:Pulmonary Disease, Chronic Obstructive D040242:Risk Reduction Behavior D055948:Sarcopenia D012720:Severity of Illness Index D017524:Slovenia
sarcopenia COPD cardiometabolic risk pulmonary rehabilitation