D3 | Abstract 04

Annual NUTRIM Symposium 18 November 2020

FUNDAMENTAL SCIENCE

Longitudinal changes in total and regional body composition in patients with COPD

Felipe V.C. Machado1,2,3,4, Martijn A. Spruit1,2,3,5, Miranda Coenjaerds6, Fabio Pitta4, Niki L. Reynaert2,3 Frits M.E. Franssen1,2,3

1Department of Research and Development, Ciro - Centre of Expertise for Chronic Organ Failure, Horn, the Netherlands.
2NUTRIM - School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands.
3Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands.
4REVAL - Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium.
5Laboratory of Research in Respiratory Physiotherapy, Department of Physical Therapy, State University of Londrina, Londrina, Brazil.
6Department of dietetics , Ciro - Centre of Expertise for Chronic Organ Failure, Horn, the Netherlands
Background:
Few studies have evaluated longitudinal changes in body composition in COPD patients compared with non-COPD controls. This study aimed to compare longitudinal changes in total and regional body composition between COPD patients and non-COPD controls and to investigate predictors of changes in body composition in COPD.

Methods:
COPD patients and non-COPD controls participating in the ICE-Age study, a single-centre, longitudinal, observational study, were included. Subjects were assessed at baseline and after two years of follow-up regarding a comprehensive assessment of lung function and body composition (by dual energy x-ray absorptiometry (DEXA) scan). The number of exacerbations/hospitalizations before inclusion and during two years of follow-up were assessed in COPD patients. Mean differences [95% confidence interval] were calculated from univariate general linear models. Multiple stepwise regression was used to investigate predictors of changes in total and regional fat-free mass (FFM). Statistical significance was defined as P value <0.05.

Results:
405 subjects were included for analysis (205 COPD patients, 87 smoking and 113 non-smoking controls). Patients with COPD presented a greater decline in total fat-free mass (FFM) than smoking (-688[-1296/-79]g) and non-smoking controls (-986[-1.544/-0.427]g). This decline was more pronounced in their legs (-634[-994/-273]g vs smoking and -507[-837/-178]g vs non-smoking controls) and trunk (-139[-584/307]g vs smoking and -492[-901/-84]g vs non-smoking controls) than in arms (-51[-182/80]g vs smoking and 23[-97/144]g vs non-smoking controls). The predictors of changes in total and regional FFM in patients with COPD were: sex, number of hospitalizations one year before baseline, baseline values of FFM and body mass index (BMI) (P<0.05 for all).

Conclusion:
Patients with COPD present greater decline in FFM than non-COPD controls. This decline is regionally located on legs and trunk rather than arms. Higher baseline values of FFM and occurrence of previous hospitalizations were identified as the main predictors of changes in total and regional FFM.
OVERVIEW D3 ABSTRACTS OVERVIEW APPLIED SCIENCE

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NUTRIM aims to contribute to health maintenance and personalised medicine by unraveling lifestyle and disease-induced derangements in metabolism and by developing targeted nutritional, exercise and drug interventions. This is facilitated by a state of the art research infrastructure and close interaction between scientists, clinicians, master and PhD students.
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