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Noh E, Jeong H, Cho IS, Chang MS, Yu I, Park S, Lee JH, Lee SJ, Lee WY, Yong SJ, Kim SH. Risk of Cardiovascular Events Associated with Chronic Obstructive Pulmonary Disease and/or Metabolic Syndrome: A Large-Scale Nationwide Population-Based Cohort Study. Int J Chron Obstruct Pulmon Dis 2024; 19:1447-1456. [PMID: 38948908 PMCID: PMC11214538 DOI: 10.2147/copd.s458779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 06/18/2024] [Indexed: 07/02/2024] Open
Abstract
Purpose Chronic obstructive pulmonary disease (COPD) and metabolic syndrome (MetS) are among the most prevalent conditions that might predispose individuals to life-threatening events. We aimed to examine their associations with cardiovascular (CV) events and mortality using a large-scale population dataset from the National Health Information Database in Korea. Patients and Methods This population-based cohort study enrolled adults aged ≥40 years who had undergone more than two health examinations between 2009 and 2011. They were divided into four groups based on the presence of COPD and MetS. Analysis of the outcomes and CV events or deaths was performed from 2014 to 2019. We compared CV event incidence and mortality rates using a multivariate Cox proportional hazards model and Kaplan-Meier curves. Results Totally, 5,101,810 individuals were included, among whom 3,738,458 (73.3%) had neither COPD nor MetS, 1,193,014 (23.4%) had only MetS, 125,976 (2.5%) had only COPD, and 44,362 (0.9%) had both. The risk of CV events was significantly higher in individuals with both COPD and MetS than in those with either COPD or MetS alone (HRs: 2.4 vs 1.6 and 1.8, respectively; all P <0.001). Similarly, among those with both COPD and MetS, all-cause and CV mortality risks were also elevated (HRs, 2.9 and 3.0, respectively) compared to the risks in those with either COPD (HRs, 2.6 and 2.1, respectively) or MetS (HRs, 1.7 and 2.1, respectively; all P <0.001). Conclusion The comorbidity of MetS in patients with COPD increases the incidence of CV events and all-cause and cardiovascular mortality rates.
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Affiliation(s)
- Enkyu Noh
- Yonsei University Wonju College of Medicine, Wonju, 26426, Korea
| | - Hyungmin Jeong
- Yonsei University Wonju College of Medicine, Wonju, 26426, Korea
| | - In-So Cho
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, 26426, Korea
| | - Min-Seok Chang
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, 26426, Korea
| | - Iseul Yu
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, 26426, Korea
| | - Sunmin Park
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, 26426, Korea
| | - Ji-Ho Lee
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, 26426, Korea
| | - Seok Jeong Lee
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, 26426, Korea
| | - Won-Yeon Lee
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, 26426, Korea
| | - Suk Joong Yong
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, 26426, Korea
| | - Sang-Ha Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, 26426, Korea
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Deutz LN, Wierzchowska-McNew RA, Deutz NE, Engelen MP. Reduced plasma glycine concentration in healthy and chronically diseased older adults: a marker of visceral adiposity? Am J Clin Nutr 2024; 119:1455-1464. [PMID: 38616018 PMCID: PMC11251212 DOI: 10.1016/j.ajcnut.2024.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 02/14/2024] [Accepted: 04/08/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Previous studies have shown that a reduced plasma concentration of the amino acid glycine (Gly) is associated with intra-abdominal obesity, but the mechanism remains unclear. OBJECTIVES This study aimed to investigate whether lower plasma Gly concentrations in older adults are independently associated with (visceral) adiposity, age, sex, presence of chronic disease, and glucose intolerance, and whether they are caused by a reduced Gly whole-body production (WBP) and/or increased Gly disposal capacity. METHODS We studied 102 older adults (47 males/55 females, 68.5 ± standard deviation 6.4 y) without comorbidities and 125 older adults with chronic obstructive pulmonary disease (COPD) (58 males/67 females, 69.7 ± 8.6 y). We assessed body composition and visceral adipose tissue (VAT) by dual-energy x-ray absorptiometry and muscle function by dynamometry. We measured postabsorptive plasma amino acid profile and glucose, followed by pulse administration of stable isotope-labeled Gly ([2,2-2H2]), and blood sampling was performed to measure the WBP of Gly. Results are expressed as means and 95% confidence intervals (CIs). RESULTS We found a lower plasma Gly concentration in healthy males and males with COPD than in females (Healthy: 211; 95% CI: 193,230 compared with 248; 95% CI: 225,271; COPD: 200; 95% CI: 186,215 compared with 262: 95% CI: 241, 283; P < 0.0001, respectively), with no difference between healthy and COPD groups. A negative relationship was found between unadjusted plasma Gly and VAT mass (R2: 0.16; slope: -1.7; 95% CI: -2.4, -1.2; P < 0.0021), but not with total body fat or fasting glucose. The strong association between lower plasma Gly and increased VAT mass in older adults was independent of age, sex, body weight, lean mass or body mass index, and the presence of COPD. Inclusion of these covariates increased the R2 to 0.783. We found no relation between the VAT and WBP of Gly (P = 0.35) or Gly clearance (P = 0.187) when lean mass was considered. CONCLUSIONS Reduced plasma Gly in older adults can be considered a marker of visceral adiposity, independent of sex, age, body composition, presence of chronic disease, and whole-body Gly production or clearance. This study was registered on clinicaltrials.gov as NCT01787682, NCT02082418, NCT02157844, NCT02770092, NCT02780219, NCT03796455, and NCT04461236.
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Affiliation(s)
- Lars Nj Deutz
- Center for Translational Research in Aging and Longevity, Department of Kinesiology and Sport Management, Texas A&M University, College Station, TX, United States
| | - Raven A Wierzchowska-McNew
- Center for Translational Research in Aging and Longevity, Department of Kinesiology and Sport Management, Texas A&M University, College Station, TX, United States
| | - Nicolaas Ep Deutz
- Center for Translational Research in Aging and Longevity, Department of Kinesiology and Sport Management, Texas A&M University, College Station, TX, United States; Department of Primary Care and Rural Medicine, Texas A&M School of Medicine, College Station, TX, United States
| | - Mariëlle Pkj Engelen
- Center for Translational Research in Aging and Longevity, Department of Kinesiology and Sport Management, Texas A&M University, College Station, TX, United States; Department of Primary Care and Rural Medicine, Texas A&M School of Medicine, College Station, TX, United States.
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Calañas-Continente A, Gutiérrez-Botella J, García-Currás J, Cobos MJ, Vaquero JM, Herrera A, Molina MJ, Gálvez MÁ. Global Leadership Initiative on Malnutrition-Diagnosed Malnutrition in Lung Transplant Candidates. Nutrients 2024; 16:376. [PMID: 38337661 PMCID: PMC10857078 DOI: 10.3390/nu16030376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND AND AIMS Malnutrition in lung transplantation (LT) candidates increases postoperative morbidity and mortality. Early diagnosis of malnutrition could attenuate adverse prognostic factors. This study aimed to assess the prevalence of nutritional risk and malnutrition using GLIM criteria in LT candidates and clinically characterize those with malnutrition. METHODS A prospective longitudinal study was conducted from 2000 to 2020 of LT candidates who underwent complete nutritional assessment (nutritional screening, anthropometry, bioelectrical impedance, blood laboratory tests and malnutrition diagnosis using GLIM criteria). RESULTS Obstructive diseases (45.6%), interstitial diseases (36.6%) and cystic fibrosis/non-cystic fibrosis bronchiectasis (15.4%) were the main conditions assessed for LT. Of the 1060 candidates evaluated, 10.6% were underweight according to BMI, 29% were at risk of malnutrition and 47% were diagnosed with malnutrition using GLIM criteria. Reduced muscle mass was the most frequent GLIM phenotypic criterion. Malnutrition was more prevalent in patients with cystic fibrosis/non-cystic fibrosis bronchiectasis (84.5%) and obstructive (45.4%) and interstitial (31.3%) diseases. GLIM criteria detected some degree of malnutrition in all diseases requiring LT and identified patients with higher CRP levels and worse respiratory function, anthropometric measurements and visceral protein and lipid profiles. CONCLUSIONS LT candidates present a high prevalence of malnutrition using the GLIM algorithm. GLIM criteria detected malnutrition in all diseases requiring LT and defined patients with worse clinical-analytical profiles.
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Affiliation(s)
- Alfonso Calañas-Continente
- Department of Endocrinology and Nutrition, University Hospital Reina Sofia, Avenida Menendez Pidal s/n, 14004 Cordoba, Spain; (A.H.); (M.J.M.); (M.Á.G.)
| | - Jesús Gutiérrez-Botella
- Biostatech Advice Training and Innovation in Biostatistics, SL. Edificio Emprendia, Campus Vida s/n, 15782 Santiago de Compostela, Spain; (J.G.-B.); (J.G.-C.)
| | - Julia García-Currás
- Biostatech Advice Training and Innovation in Biostatistics, SL. Edificio Emprendia, Campus Vida s/n, 15782 Santiago de Compostela, Spain; (J.G.-B.); (J.G.-C.)
| | - Mª Jesús Cobos
- Department of Pulmonary Medicine and Lung Transplantation, University Hospital Reina Sofia, Avenida Menendez Pidal s/n, 14004 Cordoba, Spain; (M.J.C.); (J.M.V.)
| | - José Manuel Vaquero
- Department of Pulmonary Medicine and Lung Transplantation, University Hospital Reina Sofia, Avenida Menendez Pidal s/n, 14004 Cordoba, Spain; (M.J.C.); (J.M.V.)
| | - Aura Herrera
- Department of Endocrinology and Nutrition, University Hospital Reina Sofia, Avenida Menendez Pidal s/n, 14004 Cordoba, Spain; (A.H.); (M.J.M.); (M.Á.G.)
| | - Mª José Molina
- Department of Endocrinology and Nutrition, University Hospital Reina Sofia, Avenida Menendez Pidal s/n, 14004 Cordoba, Spain; (A.H.); (M.J.M.); (M.Á.G.)
| | - Mª Ángeles Gálvez
- Department of Endocrinology and Nutrition, University Hospital Reina Sofia, Avenida Menendez Pidal s/n, 14004 Cordoba, Spain; (A.H.); (M.J.M.); (M.Á.G.)
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Kim J, Kang S, Kang H. Normal-Weight Obesity and Metabolic Syndrome in Korean Adults: A Population-Based Cross-Sectional Study. Healthcare (Basel) 2023; 11:2303. [PMID: 37628501 PMCID: PMC10454074 DOI: 10.3390/healthcare11162303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/03/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND The disadvantage of using body mass index (BMI) as an obesity diagnostic tool is that it cannot distinguish between fat mass and lean mass, which may understate the impact of obesity on metabolic complications. This population-based cross-sectional study aimed to investigate the relationship between normal-weight obesity (NWO) and metabolic syndrome in Korean adults aged 20 years (5962 males and 6558 females) who took part in the Korea National Health and Nutrition Examination Surveys from 2008 to 2011. METHODS NWO was defined as having a BMI of 18.5 to 24.9 kg/m2 and a body fat percentage of 26.0% in males or 36.0% in females. Metabolic syndrome (MetS) was defined using the revised National Cholesterol Education Program definition, with a Korean-specific waist circumference threshold of >90 cm for males and >85 cm for females. RESULTS NWO males and females were 2.7 times (p < 0.001) and 1.9 times (p < 0.001) more likely to develop metabolic syndrome than normal-weight non-obese males and females, respectively. Additionally, NWO females were 1.3 times (p = 0.027) more likely to develop MetS even after adjustments for all measured covariates. CONCLUSIONS The current findings of the study show that NWO is a proxy biomarker of MetS to be considered for early intervention.
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Affiliation(s)
| | | | - Hyunsik Kang
- College of Sport Science, Sungkyunkwan University, Suwon 16419, Republic of Korea; (J.K.); (S.K.)
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Wu ZY, Lu XM, Liu R, Han YX, Qian HY, Zhao Q, Niu M. Impaired Skeletal Muscle in Patients with Stable Chronic Obstructive Pulmonary Disease (COPD) Compared with Non-COPD Patients. Int J Chron Obstruct Pulmon Dis 2023; 18:1525-1532. [PMID: 37489239 PMCID: PMC10363356 DOI: 10.2147/copd.s396728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 07/03/2023] [Indexed: 07/26/2023] Open
Abstract
Purpose This study was designed to investigate the differences in skeletal-muscle atrophy between patients with stable chronic obstructive pulmonary disease (COPD) and healthy controls; associated factors were also considered. The study comprised selected residents of communities near the First Affiliated Hospital of Soochow University in Suzhou City, East China. Patients and Methods Included in this study were 123 COPD patients and 60 controls. All patients completed spirometry as well as examinations to determine their functional exercise capacity, body composition, and handgrip strength (HGS). Results COPD patients had less fat-free mass (FFM), a lower FFM index (FFMI), and a lower 6-min walking distance (6MWD) compared with controls (P = 0.007, P = 0.020, and P < 0.001, respectively) (FFMI: 17.59 ± 1.83 vs 18.34 ± 1.64). The HGS of these patients was also lower compared with that of controls (32.88 ± 7.84 vs 35.48 ± 7.42), and HGS tended toward statistical significance (P = 0.064, respectively). In multivariate analysis, age (β = -0.107, P < 0.001), gender (β = 0.212, P < 0.001), body mass index (BMI) (β = 0.462, P < 0.001), FEV1% (β = 0.108, P = 0.009), and calf circumference (CC) (β = 0.457, P < 0.001) were significantly associated with FFMI. Conclusion Impaired skeletal muscle mass was more common in COPD patients than in controls. Multiple regression analysis showed that CC may be used to detect the degree of impairment, particularly by health-care providers working outside of the hospital.
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Affiliation(s)
- Zhen-Yun Wu
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China
| | - Xiang-Min Lu
- School of Nursing, Suzhou Medical College of Soochow University, Suzhou, People’s Republic of China
| | - Rui Liu
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China
| | - Yan-Xia Han
- Department of Nursing, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China
| | - Hong-Ying Qian
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China
| | - Qian Zhao
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China
| | - Mei’e Niu
- Department of Nursing, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China
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Beijers RJHCG, Steiner MC, Schols AMWJ. The role of diet and nutrition in the management of COPD. Eur Respir Rev 2023; 32:32/168/230003. [PMID: 37286221 DOI: 10.1183/16000617.0003-2023] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 03/27/2023] [Indexed: 06/09/2023] Open
Abstract
In 2014, the European Respiratory Society published a statement on nutritional assessment and therapy in COPD. Since then, increasing research has been performed on the role of diet and nutrition in the prevention and management of COPD. Here, we provide an overview of recent scientific advances and clinical implications. Evidence for a potential role of diet and nutrition as a risk factor in the development of COPD has been accumulating and is reflected in the dietary patterns of patients with COPD. Consuming a healthy diet should, therefore, be promoted in patients with COPD. Distinct COPD phenotypes have been identified incorporating nutritional status, ranging from cachexia and frailty to obesity. The importance of body composition assessment and the need for tailored nutritional screening instruments is further highlighted. Dietary interventions and targeted single or multi-nutrient supplementation can be beneficial when optimal timing is considered. The therapeutic window of opportunity for nutritional interventions during and recovering from an acute exacerbation and hospitalisation is underexplored.
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Affiliation(s)
- Rosanne J H C G Beijers
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Michael C Steiner
- Leicester NIHR Biomedical Research Centre - Respiratory, Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Annemie M W J Schols
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
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Gupta RD, Tamanna N, Siddika N, Haider SS, Apu EH, Haider MR. Obesity and Abdominal Obesity in Indian Population: Findings from a Nationally Representative Study of 698,286 Participants. EPIDEMIOLOGIA 2023; 4:163-172. [PMID: 37218876 DOI: 10.3390/epidemiologia4020017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/30/2023] [Accepted: 05/05/2023] [Indexed: 05/24/2023] Open
Abstract
This study aims to determine and compare the prevalence and correlates of obesity and abdominal obesity in India among participants aged 18-54 years. Data were acquired from the nationally representative National Family Health Survey 2019-21. Age and sex standardized descriptive analyses were conducted to determine the prevalence of obesity and abdominal obesity, and multivariable multilevel logistic regression was performed to identify the factors associated with these conditions. Gender-specific analyses were also conducted. The sample weight was adjusted throughout. The final sample size for this study was 698,286. The prevalence of obesity and abdominal obesity was 13.85% and 57.71%, respectively. Older age, being female, increased educational status and increased wealth index, being married at any point, and residing in an urban area all increased the odds of both obesity and abdominal obesity. Being a resident of the North zone and having a current alcohol intake increased the odds of abdominal obesity. On the other hand, being a resident of the South zone of India increased the odds of obesity. Targeting these high-risk groups can be a strategy for public health promotion programs.
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Affiliation(s)
- Rajat Das Gupta
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29028, USA
| | - Nowrin Tamanna
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29028, USA
| | - Nazeeba Siddika
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA
- Centre for International Public Health and Environmental Research, Bangladesh (CIPHER,B), Dhaka 1207, Bangladesh
| | - Shams Shabab Haider
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD 21205, USA
| | - Ehsanul Hoque Apu
- Centre for International Public Health and Environmental Research, Bangladesh (CIPHER,B), Dhaka 1207, Bangladesh
- Department of Biomedical Engineering, Institute for Quantitative Health Science and Engineering (IQ), Michigan State University, East Lansing, MI 48824, USA
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, 90220 Oulu, Finland
| | - Mohammad Rifat Haider
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA 30602, USA
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Cruthirds CL, Deutz NEP, Mizubuti YGG, Harrykissoon RI, Zachria AJ, Engelen MPKJ. Abdominal obesity in COPD is associated with specific metabolic and functional phenotypes. Nutr Metab (Lond) 2022; 19:79. [PMID: 36457012 PMCID: PMC9714145 DOI: 10.1186/s12986-022-00714-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 11/20/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Abdominal obesity (AO) is linked to reduced health status and mortality. While it is known that AO is prevalent in chronic obstructive pulmonary disease (AO-COPD), the specific metabolic and functional consequences associated with AO-COPD remain understudied. METHODS We studied 199 older adults with COPD and 168 control subjects with and without AO and assessed visceral adipose tissue (VAT) by dual-energy X-ray absorptiometry. VAT > 70th percentile of the control group qualified a subject as AO in a sex specific manner. We measured plasma concentrations and whole body production (WBP) rates of multiple amino acids to assess the metabolic profile. We assessed medical history, body composition by Dual-Energy X-ray Absorptiometry, muscle strength, and cognitive function. We performed statistics by analysis of covariance (p) and FDR (q) for multiple comparisons. RESULTS AO-COPD subjects had 27% more VAT (q < 0.01) than AO-Control subjects despite correction for BMI. Branched-chain amino acid concentrations and WBP rates were generally elevated in AO-COPD but whole body clearance rate was only elevated in COPD. Metabolic syndrome comorbidities (p < 0.01) and systemic inflammation (P < 0.05) were most prevalent in the AO-COPD group. Muscle strength was reduced in COPD subjects (p < 0.001), but partially preserved when combined with AO. Cognitive dysfunction and mood disturbances were present in COPD subjects (p < 0.001) with worst performers in AO-COPD (q < 0.05). CONCLUSION The presence of AO is associated with specific metabolic and functional phenotypes in COPD. Clinical trial registry Trial registration ClinicalTrials.gov. In the present paper, we report an analysis of the baseline measurements of COPD subjects and healthy controls from the study numbers: NCT01787682, NCT01787682, NCT02157844, NCT02082418, NCT02065141, NCT02770092, NCT02908425, NCT03159390, NCT02780219, NCT03327181, NCT03796455, NCT04928872, NCT04461236, NCT01173354, NCT01154400.
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Affiliation(s)
- Clayton L. Cruthirds
- grid.264756.40000 0004 4687 2082Center for Translational Research in Aging and Longevity, Department of Kinesiology and Sport Management, Texas A&M University, 675 John Kimbrough Blvd, College Station, TX 77840 USA
| | - Nicolaas E. P. Deutz
- grid.264756.40000 0004 4687 2082Center for Translational Research in Aging and Longevity, Department of Kinesiology and Sport Management, Texas A&M University, 675 John Kimbrough Blvd, College Station, TX 77840 USA
| | - Yani G. G. Mizubuti
- grid.264756.40000 0004 4687 2082Center for Translational Research in Aging and Longevity, Department of Kinesiology and Sport Management, Texas A&M University, 675 John Kimbrough Blvd, College Station, TX 77840 USA
| | - Rajesh I. Harrykissoon
- Pulmonary, Critical Care and Sleep Medicine, Scott and White Medical Center, College Station, TX USA
| | - Anthony J. Zachria
- Pulmonary, Critical Care and Sleep Medicine, Scott and White Medical Center, College Station, TX USA
| | - Mariëlle P. K. J. Engelen
- grid.264756.40000 0004 4687 2082Center for Translational Research in Aging and Longevity, Department of Kinesiology and Sport Management, Texas A&M University, 675 John Kimbrough Blvd, College Station, TX 77840 USA
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Physical Activity, Exercise Capacity, and Body Composition in U.S. Veterans with Chronic Obstructive Pulmonary Disease (COPD). Ann Am Thorac Soc 2022; 19:1669-1676. [PMID: 35536690 DOI: 10.1513/annalsats.202111-1221oc] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
RATIONALE Differences in body composition may contribute to variability in exercise capacity (EC) and physical activity (PA) in chronic obstructive pulmonary disease (COPD). Most studies have employed bioimpedance-based surrogates of muscle (lean) mass; relatively few studies have included consideration of fat mass and limited studies have been performed using dual X-ray absorptiometry (DXA)-assessed body composition. OBJECTIVE To determine whether DXA-assessed muscle (lean) and fat mass exhibit differential correlations with EC and PA in COPD Methods: US Veterans with COPD (defined as FEV1/FVC<0.7 or emphysema on clinical chest computed tomography) had DXA-assessed body composition, EC (6-minute walk distance; 6MWD), objective PA (average daily step counts), and self-reported PA measured at enrollment. Associations between EC, PA, and body composition were examined using Spearman correlations and multivariable models adjusted a priori for age, sex, race, and lung function. RESULTS Subjects (n=98) were predominantly white (88%), obese (mean BMI 30.2±6.2), and male, (94%) with a mean age (±SD) of 69.9±7.9 years and moderate airflow obstruction (mean FEV1% 68±20). Modest inverse correlations between EC and PA with fat mass were observed (Spearman's rho range [-0.20]-[-0.34]) while measures of muscle (lean) mass were not significantly associated with EC or PA. The appendicular skeletal muscle (ASM)-to-weight ratio, which considers both muscle (lean) and fat mass, was consistently associated with EC (8.4 [95%CI=2.9-13.8] meter increase on 6MWD per 1% increase in ASM-to-weight ratio), objective PA (194.8 [95%CI=15.2-374.4] steps per day per 1% increase in ASM-to-weight ratio), and self-reported PA in multivariable-adjusted models. CONCLUSION DXA-assessed body composition measures which include consideration of both lean and fat mass are associated with cross-sectional EC and PA in COPD populations. Clinical trial registered at ClinicalTrials.gov (NCT02099799).
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Motivational regulations and lifestyle in muscle-wasted COPD patients undergoing pulmonary rehabilitation. CLINICAL NUTRITION OPEN SCIENCE 2021. [DOI: 10.1016/j.nutos.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Emsley C, King S, Nyulasi I, Snell G. A GLIMmer of insight into lung transplant nutrition: Enhanced detection of malnutrition in lung transplant patients using the GLIM criteria. Clin Nutr 2021; 40:2521-2526. [PMID: 33932798 DOI: 10.1016/j.clnu.2021.02.047] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND & AIMS The Global Leadership Initiative on Malnutrition (GLIM) is a novel framework for diagnosing malnutrition and requires evaluation in wide-ranging clinical settings. This study aimed to assess the prevalence of malnutrition and its phenotypic characteristics among lung transplantation (LTx) candidates comparing GLIM to International Classification of Diseases, 10th Revision (ICD-10) criteria. METHODS A retrospective analysis was conducted of all adult patients assessed for LTx in a one-year period. Phenotypic criteria included body mass index (BMI), unintentional loss of weight (LOW) over a 12-month period and fat-free mass index (FFMI) using bioelectrical impedance analysis (BIA). Systemic inflammation associated with severe end-stage lung disease met GLIM's etiological criterion. Diagnosis of malnutrition, and its severity, were classified according to each of GLIM and ICD-10. RESULTS Of 130 patients, 112 (86%) had all data to classify malnutrition. Malnutrition prevalence according to GLIM was 59%, which was markedly greater than using ICD-10 criteria (26%). Half of the LTx patients were moderately malnourished using GLIM, compared to 19% using ICD-10. A similar proportion were severely malnourished using GLIM (9%) and ICD-10 (7%). Fat-free mass (FFM) depletion (47% of all patients) was a major contributor to GLIM-malnutrition. Over 60% of LTx patients with GLIM-malnutrition were not detected as malnourished using ICD-10 criteria. CONCLUSION Malnutrition diagnosis using GLIM was higher than using ICD-10 in LTx patients, primarily attributable to the incorporation of quantitative evaluation of FFM depletion. This highlights the utility of the GLIM framework and the importance of including body composition in malnutrition assessment.
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Affiliation(s)
- Christie Emsley
- Nutrition Department, The Alfred Hospital, 55 Commercial Rd Melbourne, Victoria, 3004, Australia.
| | - Susannah King
- Nutrition Department, The Alfred Hospital, 55 Commercial Rd Melbourne, Victoria, 3004, Australia; Department of Dietetics, Nutrition and Sport, LaTrobe University, Bundoora, Victoria, 3068, Australia.
| | - Ibolya Nyulasi
- Nutrition Department, The Alfred Hospital, 55 Commercial Rd Melbourne, Victoria, 3004, Australia; Department of Dietetics, Nutrition and Sport, LaTrobe University, Bundoora, Victoria, 3068, Australia; Department of Medicine, Central Clinical School, Monash University, 99 Commercial Rd, Melbourne, Victoria 3004, Australia.
| | - Gregory Snell
- Lung Transplant Service, The Alfred Hospital, 55 Commercial Rd Melbourne, Victoria, 3004, Australia.
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12
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Wilkinson DJ, Rodriguez-Blanco G, Dunn WB, Phillips BE, Williams JP, Greenhaff PL, Smith K, Gallagher IJ, Atherton PJ. Untargeted metabolomics for uncovering biological markers of human skeletal muscle ageing. Aging (Albany NY) 2020; 12:12517-12533. [PMID: 32580166 PMCID: PMC7377844 DOI: 10.18632/aging.103513] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 06/04/2020] [Indexed: 02/07/2023]
Abstract
Ageing compromises skeletal muscle mass and function through poorly defined molecular aetiology. Here we have used untargeted metabolomics using UHPLC-MS to profile muscle tissue from young (n=10, 25±4y), middle aged (n=18, 50±4y) and older (n=18, 70±3y) men and women (50:50). Random Forest was used to prioritise metabolite features most informative in stratifying older age, with potential biological context examined using the prize-collecting Steiner forest algorithm embedded in the PIUMet software, to identify metabolic pathways likely perturbed in ageing. This approach was able to filter a large dataset of several thousand metabolites down to subnetworks of age important metabolites. Identified networks included the common age-associated metabolites such as androgens, (poly)amines/amino acids and lipid metabolites, in addition to some potentially novel ageing related markers such as dihydrothymine and imidazolone-5-proprionic acid. The present study reveals that this approach is a potentially useful tool to identify processes underlying human tissue ageing, and could therefore be utilised in future studies to investigate the links between age predictive metabolites and common biomarkers linked to health and disease across age.
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Affiliation(s)
- Daniel J Wilkinson
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Nottingham, Nottingham, UK.,National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK.,School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
| | - Giovanny Rodriguez-Blanco
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Nottingham, Nottingham, UK.,School of Biosciences and Phenome Centre Birmingham, University of Birmingham, Birmingham, Birmingham, UK.,Beatson Institute for Cancer Research, Glasgow, UK
| | - Warwick B Dunn
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Nottingham, Nottingham, UK.,School of Biosciences and Phenome Centre Birmingham, University of Birmingham, Birmingham, Birmingham, UK
| | - Bethan E Phillips
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Nottingham, Nottingham, UK.,National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK.,School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
| | - John P Williams
- School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
| | - Paul L Greenhaff
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Nottingham, Nottingham, UK.,National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK.,School of Life Sciences, University of Nottingham, Queens Medical Centre, Nottingham, UK
| | - Kenneth Smith
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Nottingham, Nottingham, UK.,National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK.,School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
| | - Iain J Gallagher
- University of Stirling, Faculty of Health Sciences and Sport, Stirling, UK
| | - Philip J Atherton
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Nottingham, Nottingham, UK.,National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK.,School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
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13
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Brook MS, Wilkinson DJ, Atherton PJ. An update on nutrient modulation in the management of disease-induced muscle wasting: evidence from human studies. Curr Opin Clin Nutr Metab Care 2020; 23:174-180. [PMID: 32175954 DOI: 10.1097/mco.0000000000000652] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW Skeletal muscle has many essential roles in maintaining human health, not only being crucial for locomotion, but further as a metabolically important organ. Muscle wasting in disease (cachexia) is highly prevalent, associated with poor clinical outcomes and is not fully reversible with nutritional interventions. Understanding proteostasis in diseased states is of great importance to design novel, effective nutritional/nutraceutical strategies aimed at alleviating muscle wasting. In this review, we will provide an update on muscle kinetics in disease and the effects of nutritional interventions. RECENT FINDINGS Whole body and skeletal muscle kinetics are commonly shown to be imbalanced in disease, promoting overall catabolism that underlies the development of cachexia. However, recent advancements in defining the effectiveness of nutritional interventions on muscle anabolism are clouded by heterogenous patient populations and a lack of direct incorporation stable isotope techniques. Current recommendations are focused on combating malnutrition, with increased protein intake (high in EAA) demonstrating promise. SUMMARY Recent progress in understanding catabolic states in cachexia across disease is minimal. Further, studies investigating muscle-specific protein turnover along with nutritional interventions are scarce. As such, there is a significant requirement for strong RCT's investigating both acute and chronic nutritional interventions and their impact on skeletal muscle in individual disease states.
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Affiliation(s)
- Matthew S Brook
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Clinical, Metabolic and Molecular Physiology, National Institute for Health Research Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Derby
- Queens Medical Centre, Nottingham, UK
| | - Daniel J Wilkinson
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Clinical, Metabolic and Molecular Physiology, National Institute for Health Research Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Derby
| | - Philip J Atherton
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Clinical, Metabolic and Molecular Physiology, National Institute for Health Research Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Derby
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14
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Han Y, Wu Z, Chen Y, Kan Y, Geng M, Xu N, Qian H, Wang HF, Niu M. Factors associated with appendicular skeletal muscle mass among male Chinese patients with stable chronic obstructive pulmonary disease: A hospital-based cross-sectional study. Medicine (Baltimore) 2019; 98:e17361. [PMID: 31577733 PMCID: PMC6783162 DOI: 10.1097/md.0000000000017361] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Limbs muscle wasting is a common disorder in patients with chronic obstructive pulmonary disease (COPD) that limits daily activities and exercise intolerance, especially in males. The present study aimed to estimate the prevalence of appendicular skeletal muscle mass (ASM) in male patients with stable COPD. In addition, factors associated with parameters of ASM were also investigated.We recruited 116 male patients with stable COPD from the outpatient clinic between September 2016 and December 2017. For each patient, we obtained demographic characteristics and measured post-bronchodilator forced expiratory volume in 1 second, symptoms, exacerbations history, and ASM. ASM was defined as the sum of the muscle masses of the 4 limbs.Appendicular skeletal muscle mass index (ASMI) in male patients with stable COPD was 8.2 ± 0.9 kg/m, and the prevalence of low skeletal muscle mass was 7.8% (9 of 116 patients). Multiple linear-regression analysis showed that body mass index, occupation, fat-free mass index, and the modified medical research council scale were significantly correlated with ASMI. Compared with nonexercise group, lower limb muscle mass and ASM were significantly improved in physical exercise group.Underweight, retirement, fat-free mass depletion, and severe dyspnea are all risk factors for ASM in male patients with stable COPD. Our findings also justify the importance of exercise training in improving ASM.
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Affiliation(s)
- Yanxia Han
- Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University
| | - Zhenyun Wu
- Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University
| | - Yi Chen
- Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University
| | - Yanan Kan
- School of Nursing, Soochow University, Suzhou, China
| | - Min Geng
- School of Nursing, Soochow University, Suzhou, China
| | - Nuo Xu
- School of Nursing, Soochow University, Suzhou, China
| | - Hongying Qian
- Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University
| | - Hai Fang Wang
- Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University
| | - Meie Niu
- Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University
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15
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Spruit MA, Rochester CL, Pitta F, Kenn K, Schols AMWJ, Hart N, Wouters EFM, Nava S, Dreher M, Janssen DJA, Johnson MJ, Curtis RJ, Sastry M, Franssen FME. Pulmonary rehabilitation, physical activity, respiratory failure and palliative respiratory care. Thorax 2019; 74:693-699. [PMID: 30872364 DOI: 10.1136/thoraxjnl-2018-212044] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 02/07/2019] [Accepted: 02/11/2019] [Indexed: 12/13/2022]
Abstract
The CIRO Academy in Horn (the Netherlands) organised a 2-day meeting to present and discuss the studies published in 2017 pertaining to key priority areas of respiratory and critical care medicine. This review summarises studies focussing on pulmonary rehabilitation and exercise training, physical activity, chronic respiratory failure and palliative respiratory care published in 2017.
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Affiliation(s)
- Martijn A Spruit
- REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium .,Department of Research and Education, CIRO, Horn, The Netherlands.,Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), NUTRIMSchool of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
| | - Carolyn L Rochester
- Section of Pulmonary and Critical Care, Yale University School of Medicine, New Haven, Connecticut, USA.,VA Connecticut Healthcare System, West Haven, CT, United States
| | - Fabio Pitta
- Department of Physiotherapy, Laboratory of Research in Respiratory Physiotherapy, Londrina, Brazil
| | - Klaus Kenn
- Department of Respiratory Medicine and Pulmonary Rehabilitation, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany.,Department of Pulmonary Rehabilitation, University of Marburg, Marburg, Germany
| | - Annemie M W J Schols
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), NUTRIMSchool of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
| | - Nicholas Hart
- Lane Fox Respiratory Service, Guy's & St Thomas' NHS Foundation Trust, London, UK.,Lane-Fox Clinical Respiratory Physiology Research Centre, Guy's and St Thomas' NHS Trust, St Thomas' Hospital, London, United Kingdom
| | - Emiel F M Wouters
- Department of Research and Education, CIRO, Horn, The Netherlands.,Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), NUTRIMSchool of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
| | - Stefano Nava
- Alma Mater University, Dept. of Clinical, Integrated and Experimental Medicine (DIMES), Respiratory and Critical Care Unit, S. Orsola-Malpighi Hospital Bologna, Bologna, Italy
| | - Michael Dreher
- Pneumology, Universitatsklinikum Aachen, Aachen, Germany
| | - Daisy J A Janssen
- Department of Research and Education, CIRO, Horn, The Netherlands.,Centre of Expertise for Palliative Care, MUMC+, Maastricht, The Netherlands
| | - Miriam J Johnson
- Wolfson Palliative Care Research Centre, Hull York Medical School, The University of Hull, Hull, UK
| | - Randall J Curtis
- Pulmonary and Critical Care Medicine, University of Washington, Seattle, Washington, USA.,Cambia Palliative Care Center of Excellence, University of Washington, Seattle, United States
| | | | - Frits M E Franssen
- Department of Research and Education, CIRO, Horn, The Netherlands.,Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), NUTRIMSchool of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
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16
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Souza RMP, Cardim AB, Maia TO, Rocha LG, Bezerra SD, Marinho PÉM. Inspiratory muscle strength, diaphragmatic mobility, and body composition in chronic obstructive pulmonary disease. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2019; 24:e1766. [PMID: 30628141 DOI: 10.1002/pri.1766] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 10/12/2018] [Accepted: 12/17/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND PURPOSE Chronic obstructive pulmonary disease (COPD) is a systemic inflammatory disease that can cause repercussions on respiratory muscles and body composition. The aim of the current study was to evaluate inspiratory muscle strength, diaphragmatic mobility, and body composition in COPD subjects and to correlate these variables. METHODS This was a cross-sectional study performed with 21 COPD patients. Inspiratory muscle strength (manovacuometry), pulmonary function test (forced vital capacity [FVC], forced expiratory volume in 1 s [FEV1 ], and FEV1 /FVC ratio), diaphragmatic mobility (ultrasonography), and body composition (bioelectrical impedance analysis) were examined. RESULTS COPD individuals in Stages II (28.9%), III (52%), and IV (19%) according to Global Initiative for Chronic Obstructive Disease were recruited, 61.9% of which were men. Inspiratory muscle weakness was found in 47.6% of subjects, who presented a lower fat-free mass percentage (p = 0.017) and smaller fat-free mass index (p = 0.001) and greater fat mass percentage (p = 0.029) and less diaphragmatic mobility (p = 0.007) compared with the nonrespiratory weakness group. Maximal inspiratory pressure exhibited a moderately positive relationship to the fat-free mass index (r = 0.767, p < 0.001) and a weak positive relationship to diaphragmatic mobility (r = 0.496, p = 0.022). CONCLUSION Our study showed a high prevalence of inspiratory muscle weakness based on the severity of airway obstruction and on the presence of muscular depletion. The evaluation of body composition detected important changes. It also demonstrated that not only muscular weakness was present in these patients but also this had repercussions on the mobility of the diaphragm muscle.
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Affiliation(s)
- Rosália M P Souza
- Cardiopulmonary Physical Therapy Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, Brazil
| | - Adriane B Cardim
- Cardiopulmonary Physical Therapy Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, Brazil
| | - Tuíra O Maia
- Cardiopulmonary Physical Therapy Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, Brazil
| | - Lívia G Rocha
- Cardiopulmonary Physical Therapy Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, Brazil
| | - Shirley D Bezerra
- Cardiopulmonary Physical Therapy Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, Brazil
| | - Patrícia Érika M Marinho
- Cardiopulmonary Physical Therapy Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, Brazil
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17
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The effect of acute and 7-days dietary nitrate on mechanical efficiency, exercise performance and cardiac biomarkers in patients with chronic obstructive pulmonary disease. Clin Nutr 2018; 37:1852-1861. [DOI: 10.1016/j.clnu.2017.10.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 09/22/2017] [Accepted: 10/19/2017] [Indexed: 11/17/2022]
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18
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Visca D, Pignatti P, Spanevello A, Lucini E, La Rocca E. Relationship between diabetes and respiratory diseases-Clinical and therapeutic aspects. Pharmacol Res 2018; 137:230-235. [PMID: 30312663 DOI: 10.1016/j.phrs.2018.10.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/28/2018] [Accepted: 10/05/2018] [Indexed: 12/16/2022]
Abstract
Diabetes is a common metabolic disorder affecting the entire body with high morbidity and mortality worldwide. The major complications related to diabetes are mostly due to the macrovascular and microvascular bed impairment due to metabolic, hemodynamic and inflammatory factors. However, studies over the past decades have added also the lung as a target organ in both type 1 and type 2 diabetes. Diabetes has always been addressed as a major comorbidity conditioning the disease behaviour and the natural history of several respiratory diseases. Increased interest has recently focused on the pathophysiology of the metabolic glycaemic disorder and the respiratory diseases suggesting a similar background shared by the two conditions. The true relationship between pulmonary diseases and diabetes mellitus has not been clarified, this review aims to summarize the link between diabetes and coexisting respiratory diseases such as asthma, chronic obstructive pulmonary disease, respiratory infections, cystic fibrosis, lung cancer and obstructive sleep apnea from a pathogenetic and therapeutic point of view.
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Affiliation(s)
- D Visca
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Italy.
| | - P Pignatti
- Allergy and Immunology Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Italy
| | - A Spanevello
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Italy; Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Tradate, Varese-Como, Italy
| | - E Lucini
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Italy; Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Tradate, Varese-Como, Italy
| | - E La Rocca
- Department of Internal Medicine, Tradate Hospital, Tradate, Italy
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19
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Vespasiani-Gentilucci U, Pedone C, Muley-Vilamu M, Antonelli-Incalzi R. The pharmacological treatment of chronic comorbidities in COPD: mind the gap! Pulm Pharmacol Ther 2018; 51:48-58. [PMID: 29966745 DOI: 10.1016/j.pupt.2018.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 06/27/2018] [Accepted: 06/29/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is commonly associated with other chronic diseases, which poses several diagnostic and therapeutic problems. Indeed, important comorbidities frequently remain unrecognized and, then, untreated, whereas respiratory drugs may have non respiratory side effects, and selected non respiratory drugs may variably affect the respiratory function. OBJECTIVE to describe: how COPD affects the presentation and contributes to the diagnostic challenges of its most common comorbidities; how coexisting COPD impacts the therapeutic approach to selected comorbidities and viceversa. METHODS we distinguish comorbidities of COPD depending upon whether they are complications of COPD or share risk factors, mainly smoke, with it or, finally, aggravate COPD. We describe atypical presentations of and diagnostic clues to comorbidities and suggest screening procedures. Finally, the main therapeutic problems, as resulting from the risk of untoward effects of therapies of COPD and its comorbidity, with special attention to drug-drug interactions and possible overdosages, are described. RESULTS selected complications of COPD, such as osteoporosis, sarcopenia and dysphagia, are rarely recognized and treated, likely due to the poor awareness of them. Important comorbidities, such as coronary artery disease, chronic heart failure, obstructive sleep apnoea syndrome and chronic renal failure, also should be systematically searched for because of their commonly variant presentation. Disease-related symptoms should be distinguished from drug effects or drug-drug interaction effects. CONCLUSIONS a truly comprehensive view of the complex COPD patient, hopefully capitalizing on multidimensional geriatric assessment, is needed to dissect the many components of health status impairment and to provide the optimal care. Selected screening procedures are highly desirable to identify frequently missed comorbidities. Pharmacosurveillance is an essential part of the approach to COPD and its comorbidities.
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Affiliation(s)
| | - Claudio Pedone
- Internal Medicine and Geriatrics Area, University Campus Bio-Medico of Rome, Italy
| | - Moises Muley-Vilamu
- Internal Medicine and Geriatrics Area, University Campus Bio-Medico of Rome, Italy
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20
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Machado FVC, Pitta F, Hernandes NA, Bertolini GL. Physiopathological relationship between chronic obstructive pulmonary disease and insulin resistance. Endocrine 2018; 61:17-22. [PMID: 29512058 DOI: 10.1007/s12020-018-1554-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 01/31/2018] [Indexed: 12/16/2022]
Abstract
PURPOSE Chronic obstructive pulmonary disease (COPD) is characterized by persistent and progressive airflow obstruction that is associated with an abnormal chronic inflammatory response in the airways and lungs to noxious particles. COPD often leads to physical inactivity and deconditioning that added to inappropriate/excessive inflammatory responses leads to systemic consequences. Studies have shown that metabolic syndrome and manifested diabetes are more frequent in COPD than in healthy subjects; a possible explanation is that different pathophysiological aspects of COPD can lead to insulin resistance. Thus, this mini-review aims to present the main studies suggesting a pathophysiological relationship between COPD and insulin resistance. METHODS A review of literature was conducted using PubMed and Web of Science databases with the aim of searching for studies supporting a relationship between COPD and insulin resistance. RESULTS A physiopathological relationship between COPD and insulin resistance was found, supported in part due to common risk factors presented by these two conditions, such as smoking and physical inactivity. Also, systemic effects (worsening of physical inactivity and sedentary behavior, inflammation and oxidative stress, body composition abnormalities) and the corticosteroid treatment of patients with COPD may play a role. CONCLUSION Patients with COPD should be screened for abnormalities in insulin sensitivity in order to reduce morbidity and improve health status in this population.
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Affiliation(s)
- Felipe Vilaça Cavallari Machado
- Department of Physiotherapy, Laboratory of Research in Respiratory Physiotherapy (LFIP), State University of Londrina (UEL), Londrina, Paraná, Brazil
| | - Fabio Pitta
- Department of Physiotherapy, Laboratory of Research in Respiratory Physiotherapy (LFIP), State University of Londrina (UEL), Londrina, Paraná, Brazil
| | - Nidia Aparecida Hernandes
- Department of Physiotherapy, Laboratory of Research in Respiratory Physiotherapy (LFIP), State University of Londrina (UEL), Londrina, Paraná, Brazil
| | - Gisele Lopes Bertolini
- Department of Physiological Sciences, State University of Londrina (UEL), Londrina, Paraná, Brazil.
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21
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Beijers RJHCG, Gosker HR, Schols AMWJ. Resveratrol for patients with chronic obstructive pulmonary disease: hype or hope? Curr Opin Clin Nutr Metab Care 2018; 21:138-144. [PMID: 29200030 PMCID: PMC5811233 DOI: 10.1097/mco.0000000000000444] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Chronic obstructive pulmonary disease (COPD) is a progressive lung disease with a high prevalence of extrapulmonary manifestations and, frequently, cardiovascular comorbidity. Resveratrol is a food-derived compound with anti-inflammatory, antioxidant, metabolic and cardioprotective potential. Therefore, resveratrol might improve the pulmonary as well as extrapulmonary pathology in COPD. In this review, we will evaluate knowledge on the effects of resveratrol on lung injury, muscle metabolism and cardiovascular risk profile and discuss if resveratrol is a hype or hope for patients with COPD. RECENT FINDINGS Experimental models of COPD consistently show decreased inflammation and oxidative stress in the lungs after resveratrol treatment. These beneficial anti-inflammatory and antioxidant properties of resveratrol can indirectly also improve both skeletal and respiratory muscle impairment in COPD. Recent clinical studies in non-COPD populations show improved mitochondrial oxidative metabolism after resveratrol treatment, which could be beneficial for both lung and muscle impairment in COPD. Moreover, preclinical studies suggest cardioprotective effects of resveratrol but results of clinical studies are inconclusive. SUMMARY Resveratrol might be an interesting therapeutic candidate to counteract lung and muscle impairments characteristic to COPD. However, there is no convincing evidence that resveratrol will significantly decrease the cardiovascular risk in patients with COPD.
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Affiliation(s)
- Rosanne J H C G Beijers
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
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22
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Sanders KJC, Ash SY, Washko GR, Mottaghy FM, Schols AMWJ. Imaging approaches to understand disease complexity: chronic obstructive pulmonary disease as a clinical model. J Appl Physiol (1985) 2017; 124:512-520. [PMID: 28751367 DOI: 10.1152/japplphysiol.00143.2017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The clinical manifestations of chronic obstructive pulmonary disease (COPD) reflect an aggregate of multiple pulmonary and extrapulmonary processes. It is increasingly clear that full assessment of these processes is essential to characterize disease burden and to tailor therapy. Medical imaging has advanced such that it is now possible to obtain in vivo insight in the presence and severity of lung disease-associated features. In this review, we have assembled data from multiple disciplines of medical imaging research to review the role of imaging in characterization of COPD. Topics include imaging of the lungs, body composition, and extrapulmonary tissue metabolism. The primary focus is on imaging modalities that are widely available in clinical care settings and that potentially contribute to describing COPD heterogeneity and enhance our insight in underlying pathophysiological processes and their structural and functional effects.
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Affiliation(s)
- Karin J C Sanders
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre , Maastricht , The Netherlands
| | - Samuel Y Ash
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital , Boston, Massachusetts
| | - George R Washko
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital , Boston, Massachusetts
| | - Felix M Mottaghy
- Department of Nuclear Medicine, Maastricht University Medical Centre , Maastricht , The Netherlands.,Department of Nuclear Medicine, University Hospital, RWTH Aachen University , Aachen , Germany
| | - Annemie M W J Schols
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre , Maastricht , The Netherlands
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