Respiratory exacerbations are associated with muscle loss in current and former smokers
© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ..
OBJECTIVES: Muscle wasting is a recognised extra-pulmonary complication in chronic obstructive pulmonary disease and has been associated with increased risk of death. Acute respiratory exacerbations are associated with reduction of muscle function, but there is a paucity of data on their long-term effect. This study explores the relationship between acute respiratory exacerbations and long-term muscle loss using serial measurements of CT derived pectoralis muscle area (PMA).
DESIGN AND SETTING: Participants were included from two prospective, longitudinal, observational, multicentre cohorts of ever-smokers with at least 10 pack-year history.
PARTICIPANTS: The primary analysis included 1332 (of 2501) participants from Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) and 4384 (of 10 198) participants from Genetic Epidemiology of COPD (COPDGene) who had complete data from their baseline and follow-up visits.
INTERVENTIONS: PMA was measured on chest CT scans at two timepoints. Self-reported exacerbation data were collected from participants in both studies through the use of periodic longitudinal surveys.
MAIN OUTCOME MEASURES: Age-related and excess muscle loss over time.
RESULTS: Age, sex, race and body mass index were associated with baseline PMA. Participants experienced age-related decline at the upper end of reported normal ranges. In ECLIPSE, the exacerbation rate over time was associated with an excess muscle area loss of 1.3% (95% CI 0.6 to 1.9, p<0.001) over 3 years and in COPDGene with an excess muscle area loss of 2.1% (95% CI 1.2 to 2.8, p<0.001) over 5 years. Excess muscle area decline was absent in 273 individuals who participated in pulmonary rehabilitation.
CONCLUSIONS: Exacerbations are associated with accelerated skeletal muscle loss. Each annual exacerbation was associated with the equivalent of 6 months of age-expected decline in muscle mass. Ameliorating exacerbation-associated muscle loss represents an important therapeutic target.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:76 |
|---|---|
| Enthalten in: |
Thorax - 76(2021), 6 vom: 20. Juni, Seite 554-560 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Mason, Stefanie Elizabeth [VerfasserIn] |
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| Links: |
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| Themen: |
COPD exacerbations |
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| Anmerkungen: |
Date Completed 13.07.2021 Date Revised 13.04.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1136/thoraxjnl-2020-215999 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Mason, Stefanie Elizabeth |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Respiratory exacerbations are associated with muscle loss in current and former smokers |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Completed 13.07.2021 | ||
| 500 | |a Date Revised 13.04.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a OBJECTIVES: Muscle wasting is a recognised extra-pulmonary complication in chronic obstructive pulmonary disease and has been associated with increased risk of death. Acute respiratory exacerbations are associated with reduction of muscle function, but there is a paucity of data on their long-term effect. This study explores the relationship between acute respiratory exacerbations and long-term muscle loss using serial measurements of CT derived pectoralis muscle area (PMA) | ||
| 520 | |a DESIGN AND SETTING: Participants were included from two prospective, longitudinal, observational, multicentre cohorts of ever-smokers with at least 10 pack-year history | ||
| 520 | |a PARTICIPANTS: The primary analysis included 1332 (of 2501) participants from Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) and 4384 (of 10 198) participants from Genetic Epidemiology of COPD (COPDGene) who had complete data from their baseline and follow-up visits | ||
| 520 | |a INTERVENTIONS: PMA was measured on chest CT scans at two timepoints. Self-reported exacerbation data were collected from participants in both studies through the use of periodic longitudinal surveys | ||
| 520 | |a MAIN OUTCOME MEASURES: Age-related and excess muscle loss over time | ||
| 520 | |a RESULTS: Age, sex, race and body mass index were associated with baseline PMA. Participants experienced age-related decline at the upper end of reported normal ranges. In ECLIPSE, the exacerbation rate over time was associated with an excess muscle area loss of 1.3% (95% CI 0.6 to 1.9, p<0.001) over 3 years and in COPDGene with an excess muscle area loss of 2.1% (95% CI 1.2 to 2.8, p<0.001) over 5 years. Excess muscle area decline was absent in 273 individuals who participated in pulmonary rehabilitation | ||
| 520 | |a CONCLUSIONS: Exacerbations are associated with accelerated skeletal muscle loss. Each annual exacerbation was associated with the equivalent of 6 months of age-expected decline in muscle mass. Ameliorating exacerbation-associated muscle loss represents an important therapeutic target | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a COPD exacerbations | |
| 650 | 4 | |a imaging/CT MRI etc | |
| 650 | 4 | |a pulmonary rehabilitation | |
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| 700 | 1 | |a Strand, Matthew |e verfasserin |4 aut | |
| 700 | 1 | |a Baraghoshi, David |e verfasserin |4 aut | |
| 700 | 1 | |a Regan, Elizabeth A |e verfasserin |4 aut | |
| 700 | 1 | |a Bon, Jessica |e verfasserin |4 aut | |
| 700 | 1 | |a San Jose Estepar, Ruben |e verfasserin |4 aut | |
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| 700 | 1 | |a McDonald, Merry-Lynn N |e verfasserin |4 aut | |
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| 700 | 1 | |a Make, Barry J |e verfasserin |4 aut | |
| 700 | 1 | |a Dransfield, Mark T |e verfasserin |4 aut | |
| 700 | 1 | |a Han, MeiLan K |e verfasserin |4 aut | |
| 700 | 1 | |a Young, Kendra A |e verfasserin |4 aut | |
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| 700 | 1 | |a Beaty, Terri |e investigator |4 oth | |
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