Ontology highlight
ABSTRACT: Objectives
Muscle wasting is a recognised extra-pulmonary complication in chronic obstructive pulmonary disease and has been associated with increased risk of death. Acute respiratory exacerbations are associated with reduction of muscle function, but there is a paucity of data on their long-term effect. This study explores the relationship between acute respiratory exacerbations and long-term muscle loss using serial measurements of CT derived pectoralis muscle area (PMA).Design and setting
Participants were included from two prospective, longitudinal, observational, multicentre cohorts of ever-smokers with at least 10 pack-year history.Participants
The primary analysis included 1332 (of 2501) participants from Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) and 4384 (of 10 198) participants from Genetic Epidemiology of COPD (COPDGene) who had complete data from their baseline and follow-up visits.Interventions
PMA was measured on chest CT scans at two timepoints. Self-reported exacerbation data were collected from participants in both studies through the use of periodic longitudinal surveys.Main outcome measures
Age-related and excess muscle loss over time.Results
Age, sex, race and body mass index were associated with baseline PMA. Participants experienced age-related decline at the upper end of reported normal ranges. In ECLIPSE, the exacerbation rate over time was associated with an excess muscle area loss of 1.3% (95% CI 0.6 to 1.9, p<0.001) over 3 years and in COPDGene with an excess muscle area loss of 2.1% (95% CI 1.2 to 2.8, p<0.001) over 5 years. Excess muscle area decline was absent in 273 individuals who participated in pulmonary rehabilitation.Conclusions
Exacerbations are associated with accelerated skeletal muscle loss. Each annual exacerbation was associated with the equivalent of 6 months of age-expected decline in muscle mass. Ameliorating exacerbation-associated muscle loss represents an important therapeutic target.
SUBMITTER: Mason SE
PROVIDER: S-EPMC8222105 | biostudies-literature | 2021 Jun
REPOSITORIES: biostudies-literature
Mason Stefanie Elizabeth SE Moreta-Martinez Rafael R Labaki Wassim W WW Strand Matthew M Baraghoshi David D Regan Elizabeth A EA Bon Jessica J San Jose Estepar Ruben R Casaburi Richard R McDonald Merry-Lynn N MN Rossiter Harry H Make Barry J BJ Dransfield Mark T MT Han MeiLan K MK Young Kendra A KA Kinney Greg G Hokanson John E JE San Jose Estepar Raul R Washko George R GR
Thorax 20210211 6
<h4>Objectives</h4>Muscle wasting is a recognised extra-pulmonary complication in chronic obstructive pulmonary disease and has been associated with increased risk of death. Acute respiratory exacerbations are associated with reduction of muscle function, but there is a paucity of data on their long-term effect. This study explores the relationship between acute respiratory exacerbations and long-term muscle loss using serial measurements of CT derived pectoralis muscle area (PMA).<h4>Design and ...[more]