Table 3.
Studies of Body Composition and Frailty in Lung Disease
| Sarcopenia Sarcopenia is associated with frailty in lung disease | |
|---|---|
| Patient Population | Finding |
| Lung transplant candidates | Lean muscle mass was negatively correlated with frailty (by both the SPPB and FFP) (SPPB, r=−0.15; FFP, r=−0.21, p<0.05)11 |
| COPD | Frail patients had reduced SMI (8.1±1.8) and a higher proportion were sarcopenic (23.9%) compared with robust patients (SMI 8.6±1.9, p=0.002; 1.2% sarcopenic, p<0.001)3 |
| COPD | Sarcopenia was associated with higher odds of frailty (aOR 29.5, p=0.02)7 |
| Adiposity & Obesity Frailty is associated with adiposity and generally associated with obesity (measured by waist circumference and BMI) in patients with lung disease | |
| Lung transplant patients | Every 20 cm2 increase in VAT area was associated with 50% increased odds of frailty in subjects with high VAT (95% CI 1.2–1.9, p < .001), and 10% decreased odds of frailty in subjects with low VAT (95% CI 0.7–1.04, p = .12)16 |
| COPD | Higher waist circumference was associated with higher odds of frailty (aOR 1.3, p=0.01)7 |
| COPD | Frail patients had a larger waist circumference compared with those who were not (106±13 vs 104±11, p=0.041)13 |
| COPD | Frail patients had a higher BMI compared with those who were not (29±7 vs 28±5, p=0.038)13 |
| Older adults, some of whom had spirometrically defined lung disease | Frail patients had a higher BMI compared with those who were pre-frail or not frail (mean BMI: 26±3.7 not-frail, 26.6±4.0 pre-frail, 27.5±4.6 frail, p<0.001)1 |
| COPD | Differences in BMI were not significant among those who were frail compared to those who were pre-frail or robust (27.2±5.2 robust vs 27.8±6.5 pre-frail vs 27.9±7.6, p=0.71)3 |
| ILD | Differences in BMI were not significant among those who were frail compared to those who were not (mean BMI 28±4 not-frail vs 27±4 frail)10 |
| COPD | Differences in BMI were not significant among those who were frail-disabled compared with those who were not frail (mean BMI: 29±4.7 not-frail vs. 29±5.3 frail-disabled, p=0.849)2 |
| COPD | Differences in BMI were not significant across frailty severity categories (28.7±5.5 not-frail, 28.6±4.4 mildly frail, 28.5±8.4 moderately frail, 28.3±3.8 severely frail, p=0.996)8 |
| Lung transplant candidates | Differences in BMI were not significant among those who were frail compared with those who were not (24.5 (IQR 20.8–27.6) not-frail vs. 26.2 (IQR 22.4–29.8) frail, p=0.14)12 |
| COPD | Differences in BMI were not significant among those who were frail compared to those who were pre-frail or robust (27.9±4.9 not-frail vs 29.3±5.1 pre-frail vs 27.9±5.1 frail, p=0.345)6 |
| ILD | BMI was not significantly correlated with frailty (r=0.10, p=0.36)17 |
| Lung transplant candidates | Differences in BMI were not significant among those who were frail by the SPPB compared to those who were not (26.2±7.5 frail vs 26.1±4.5 not frail, p=0.93). However, frail patients by the FFP had a higher BMI compared to those who were not frail (24.1±4.6 frail vs 26.0±4.8 not frail, p=0.001)11 |
| Chronic lung disease | Differences in BMI were not significant among those who were frail compared to those who were not (data not presented in article)18 |
**
BMI= body mass index; COPD= chronic obstructive pulmonary disease; FFP= fried frailty phenotype; ILD= interstitial lung disease; IQR= interquartile range; SPPB= short physical performance battery; SMI= skeletal muscle mass; VAT= visceral adipose tissue