Body Composition of Filipino Chronic Obstructive Pulmonary Disease (COPD) Patients in Relation to Their Lung Function, Exercise Capacity and Quality of Life

Abstract

Background and objectives

The loss of muscle or fat free mass (FFM) as a result of systemic inflammation and poor nutrition in Chronic Obstructive Pulmonary Disease (COPD), is recognized as an important factor that influences symptoms and disease-related outcomes. To date, there are no data on body composition among Filipino COPD patients and how it impacts COPD disease severity. This paper examined the relationship of Fat Free Mass Index (FFMI = FFM/height) and sarcopenia with COPD disease severity variables.

Methods

This was a cross-sectional analytic study comparing low and normal FFMI, sarcopenic and nonsarcopenic COPD patients, in terms of lung function, exercise capacity, and quality of life score. Filipino COPD patients older than 40 years were included. Patients performed six minute walking distance (6MWD), handgrip strength (HGS), and quality of life status evaluation using Filipino version of COPD Assessment Test (CAT). Body composition was measured using bioelectrical impedance analysis (BIA).

Results

A total of 41 patients were included. The mean age was 69.22 years. The prevalence of being underweight and having sarcopenia was 32% and 46%, respectively. Point biserial correlation showed that COPD patients with low FFMI had a statistically significant reduction in peak inspiratory flow (r= −0.5791, P value 0.0002), peak expiratory flow (r= −0.4475, P value 0.0055), and handgrip strength (r= −0.4560, P value 0.0027); and lower CAT score (r= −0.3422, P value 0.0285). Similar findings were observed among sarcopenic COPD patients.

Conclusion

The prevalence of being underweight and having sarcopenia was high. Low FFMI results in reduction of lung function and upper limb muscle strength among Filipino COPD patients.

Keywords:

• chronic obstructive pulmonary disease
• nutrition
• body composition
• sarcopenia
• lung function

Acknowledgements

Partial funding for this project was provided through the Research Unit Fund from previous Department of Science and Technology grant of Dr. Michael Tee. The authors would like to acknowledge the assistance and support given by Dr. Jaime C. Montoya of Philippine Council for Health Research and Development and Research Grant Administration Office of the University of the Philippines Manila. The authors would like to thank Dr. Elizabeth Montemayor, Chair of the Department of Physiology, University of the Philippines- Manila, College of Medicine for lending us the body composition monitor; staff and Fellows of Division of Pulmonary Medicine; Dr. Davidson Pastrana of Nuclear Medicine; Ms. Chen Calma, Mr. Rainer Ramos and Mr. Wilson de Leon, our trained research assistants, and Dr. Emilio Villanueva III who helped us with the statistical data analysis.

Author Contributions

Study concept and design: JRC, ABA, MLT; COPD data acquisition: JRC, ABA; sarcopenia data acquisition: MLT; quality control of data and algorithms: JRC, ABA, MLT; data analysis and interpretation: JRC, ABA, MLT; statistical analysis: JRC, ABA, MLT; manuscript preparation: JRC, ABA, MLT; manuscript editing, review and final approval: JRC, ABA, MLT. All authors contributed to data analysis, drafting or revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The primary author has no conflict of interest in any form (financial, proprietary, professional) with the study, however the co-author (ABA) has acted as a paid freelance lecturer for Abbott and Nestle Philippines but did not receive funding for research carried out in this work. The authors report no other conflicts of interest in this work.