Skeletal muscle dysfunction, sarcopenia and sarcopenic obesity in patients with chronic obstructive pulmonary disease

Background. Chronic obstructive pulmonary disease (COPD) is often associated with musculoskeletal dysfunction, including skeletal muscle dysfunction, sarcopenia, osteoporosis, and obesity. The purpose was to assess skeletal muscle status and determine the prevalence of sarcopenia and sarcopenic obesity in patients with COPD. Materials and methods. 66 patients with COPD and 35 healthy subjects had been examined. Sarcopenia was established using EWGSOP2 criteria, and sarcopenic obesity was defined in the presence of sarcopenia with a body mass index >25kg/m2. Results. In 59.1% of the patients with COPD, a decrease in skeletal muscle strength was found, in particular, by 28.2% in women and by 39.1% in men at GOLD 4 in comparison with GOLD 1 and by 40.7% and 54.3%, respectively, compared to the control. A decrease in leg circumference (by 16.3% in women and by 20.8% in men) was determined at GOLD 4 compared to GOLD 1. A decrease in walking speed by 20% in women and by 27.3% in men was determined at GOLD 4 in comparison with GOLD 1 and a reliable correlation inverse connection between age and walking speed (r=–0.72 — in women and r =–0.61— in men). A significant decrease in the lean mass of the limbs was established in COPD patients over 45 years old and with GOLD 2, lean and fat mass indices— with GOLD 3, appendicular lean mass— with GOLD 4 and over 60 years old. A direct correlation link was established between the severity of COPD and android type of obesity (r = 0.41; p <0.05). Conclusions. Sarcopenia was diagnosed in 66.7% of the patients with COPD and 5.7% of the control group, and sarcopenic obesity was diagnosed in 27.3% of the patients with COPD. An increase in the share of sarcopenia was observed with age (from 50% among young people to 91.7% among subjects over 60 years old) and sarcopenic obesity (from 25% of subjects under 45 years old to 55.6% over 60 years old) and with increasing severity of COPD (from 20% with GOLD 1 to 100% with GOLD 4 and from 42.9% with GOLD 1 to 50% with GOLD 4, respectively).