Functional tests associated with sarcopenia in moderate chronic obstructive pulmonary disease

ABSTRACT

Objectives: To evaluate the association of physical and functional measures with sarcopenia in moderate chronic obstructive pulmonary disease (COPD) and to establish cutoff points for sarcopenia screening.

Methods: The study included COPD with and without sarcopenia, of both sexes who were over 50 years old. Participants were assessed for lung function, body composition, grip strength, Short Physical Performance Battery (SPPB), 5-repetition, 10-repetition and 30-s sit-to-stand tests (5STS, 10STS, and 30STS, respectively). In addition, 6-min walking test, respiratory muscular strength, and physical activity level were tested.

Results: The study had 35 participants, 24 men (68.6%) and moderate COPD (51.4%). COPD-sarcopenia showed lower values in lean mass, body fat and body mass alongside lower performance in 10 and 30 STS tests, SPPB and gait speed compared to non-sarcopenic group. The cutoff points with better sensitivity and specificity to identify sarcopenia were 10.88 and 34.14 s, 15 repetitions, and 10 points in the 5STS, 10STS, 30STS, and SPPB, respectively. The comparison of the receiver operating curves evidenced no differences between the functional tests. Only 30STS and SPPB showed acceptable discriminatory power.

Conclusion: Functional tests, especially 30STS and SPPB, are simple and affordable tools for screening sarcopenia in COPD with moderate obstruction.

KEYWORDS:

• Body composition
• chronic obstructive pulmonary disease
• exercise test
• sarcopenia

Article highlights

• Sit-to-stand tests and SPPB are simple tools for screening sarcopenia in moderate COPD.

• Sarcopenia is associated with lower functional measures in COPD.

• Age is a factor that also influences performance on functional tests.

• 30STS and SPPB showed acceptable discriminatory power for sarcopenia in COPD.

• Functional tests appear to be an additional option for evaluating patients with moderate COPD.

Acknowledgments

The authors thank the Centro Integrado de Pós-Graduação e Pesquisa em Saúde at the Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, for providing the equipment and technical support for the experiments.

Author contributions

Conception and design: V.K.S.L., G.P.S., F.A.P., ALT, A.C.R.L., V.A.M. Data collection: V.K.S.L., G.P.S., F.A.P., J.N.V.S., A.G.F.P., L.P.L., HCA. Analysis and interpretation of the data: V.K.S.L., L.P.L, P.H.S.F., H.S.C., V.A.M. Drafting of the paper: V.K.S.L., L.P.L, H.S.C., P.H.S.F., M.B.F., D.S.C., R.T., A.C.R.L., H.R.L., ALT, V.A.M. Review of manuscript: V.K.S.L., M.B.F., D.S.C., R.T., A.C.R.L., H.R.L., V.A.M. All authors read and approved the final manuscript.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

A reviewer on this manuscript has disclosed that they have received advisory fees from Roche, Novartis, Boehringer, GSK, Astra Zeneca, Sanofi, Vifor and Mundipharma within the last 36 months. Peer reviewers on this manuscript have no other relevant financial or other relationships to disclose.

Additional information

Funding

This study was supported by the Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG APQ-01886-16), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq-426952/2018-9) and the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Capes).