Abstracts Division 3
64. Prevalence and clinical impact of low muscle mass in patients with asthma.
Roy Meys, MSc1,2,3, Felipe V.C. Machado, MSc1,2,3,4, Martijn A. Spruit, PhD1,2,3, Anouk A.F. Stoffels, MSc1,5, Hieronymus W.H. van Hees, PhD5, Bram van den Borst, MD, PhD5, Peter H. Klijn, PhD6,7, Chris Burtin, PhD8, Fabio Pitta, PhD4, Frits M.E. Franssen, MD, PhD1,2,3.
1 Department of Research and Development, Ciro, Horn, The Netherlands,
2 NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands,
3 Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands, 4 Department of Physical Therapy, Laboratory of Research in Respiratory Physiotherapy, State University of Londrina, Londrina, Brazil,
5 Department of Pulmonary Diseases, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands Basalt Rehabilitation Centre, Leiden, The Netherlands,
6 Department of Pulmonology, Merem Pulmonary Rehabilitation Centre, Hilversum, the Netherlands,
7 Department of Pulmonary Medicine, Amsterdam UMC, Amsterdam, the Netherlands,
8 REVAL–Rehabilitation Research Center, BIOMED–Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
Background
One of the most prominent extra-pulmonary manifestations in patients with respiratory disease are body composition abnormalities. However, in patients with asthma specific body composition phenotypes in terms of muscle mass remain largely unidentified.
Aims
To assess (1) the prevalence of low appendicular muscle mass (ASMI) according to age-sex-BMI specific cut-offs and (2) the functional consequences of low ASMI in asthma patients, stratified into body-mass index (BMI) categories.
Methods
A retrospective observational study was conducted in 752 patients with asthma. Patients were assessed for body composition, pulmonary function, exercise capacity, quadriceps muscle function, and quality of life upon referral to pulmonary rehabilitation. The proportion of patients with low ASMI was compared among BMI categories after which clinical outcomes between patients with normal and low ASMI within each BMI category were compared.
Results
When applying age-gender-BMI-specific cut-offs, 19% of the patients could be classified as having low ASMI. Normal weight, overweight and obese class I BMI groups show a stable prevalence of low ASMI (21%, 22% and 23%, respectively), with only obese class II (8%) and III (3%) showing a significant decrease. In patients with normal weight, those with low ASMI presented lower age, pulmonary function, exercise capacity and quadriceps muscle function than those with normal ASMI (all p<0.05). Overweight patients with low ASMI presented worse pulmonary function, quadriceps muscle function and depression scores. In obese class I patients, those with low ASMI showed lower quadriceps strength and maximal oxygen uptake acquired during CPET (VO2max) was lower.
Conclusions
Approximately 20% of asthma patients presented low muscle mass when age-sex-BMI-specific ASMI cut-offs were applied. Furthermore, lower muscle mass was associated with worse functional outcomes in asthma patients. However, differences in outcomes between overweight/obese patients with normal and low ASMI were less pronounced than in normal weight patients.
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