Impact of sarcopenia on quality of life and mobility in elderly patients with chronic obstructive pulmonary disease

doi:10.16138/j.1673-6087.2023.06.002

Abstract

Abstract:

Objective To observe the status of sarcopenia in elderly patients with stable chronic obstructive pulmonary disease(COPD), and to explore its effect on quality of life and mobility in COPD patients. Methods A total of 92 patients with stable COPD in the Department of Geriatrics of Ruijin Hospital from July 2019 to April 2021 were selected and divided into sarcopenia group(n=32) and non-sarcopenia group(n=60) according to the Asian diagnostic criteria for sarcopenia. General clinical data were collected. All patients completed the pulmonary function test, grip strength and 6-meter walking speed measurement. The body composition analyzer was used to measure appendicular skeletal muscle (ASM), and the limb skeletal muscle mass index(SMI) was calculated. Symptoms of dyspnea were assessed by modified Medical Research Council Scal (mMRC) and the COPD assessment test (CAT). Pearson’s method or Spearman’s method was used to analyze the correlation between skeletal muscle assessment indexes and COPD disease assessment indexes. Multivariate stepwise Logistic regression was used to analyze the effect on mobility in the COPD patients with sarcopenia. Results The incidence of sarcopenia in the COPD patients was 34.8%. Compared with the non-sarcopenia group, the patients in the sarcopenia group were older (P<0.05), and the hemoglobin, albumin, body mass index (BMI), grip strength, 6-meter walking speed, ASM and SMI were significantly lower(P<0.01). CAT score and mMRC questionnaire score were higher than those in the non-sarcopenia group (P<0.05). BMI was positively correlated with first second forced end-expiratory volume as a percentage of estimated value（FEV₁%）(r=0.376, P=0.031） and 6-meter walking speed（r=0.436, P=0.015） in both groups, and negatively correlated with mMRC（r=-0.340, P=0.032） and CAT （r=-0.354, P=0.043）. Logistic regression analysis showed that SMI was an independent risk factor for decreased quality of life and mobility in the COPD patients after adjusting for confounding factors (P<0.05). Conclusions Sarcopenia is a common complication in elderly patients with COPD and is associated with decreased quality of life and mobility.

Key words: Aged, Chronic obstructive pulmonary disease, Sarcopenia, Quality of life and mobility

CLC Number:

R733.71

ZHAO Yajie, HE Qing, XU Zhihong. Impact of sarcopenia on quality of life and mobility in elderly patients with chronic obstructive pulmonary disease[J]. Journal of Internal Medicine Concepts & Practice, 2023, 18(06): 383-387.

Figures/Tables 3

References 23

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指标	非肌少症组（n=60）	肌少症组（n=32）	t/χ²	P
年龄（岁）	77.1±5.2	82.6±7.3	2.567	0.026
男性[n(%)]	49（81.7）	28（87.5）	0.520	0.471
白细胞计数（×10⁹/L）	6.2±1.6	6.0±1.4	0.609	0.544
血红蛋白（g/L）	126.9±14.5	114.6±13.9	4.087	0.002
白蛋白（g/L）	38.7±3.4	34.6±3.5	5.470	0.009
尿酸（μmol/L）	332.6±51.0	334.2±51.1	0.053	0.948
肌酐（μmol/L）	76.4±10.9	80.9±11.5	0.860	0.552
总胆固醇（mmol/L）	4.1±0.9	4.3±1.1	1.905	0.058
甘油三酯（mmol/L）	1.4±0.7	1.6±0.9	1.825	0.069
血清钾（mmol/L）	3.7±0.5	3.8±0.4	0.657	0.624
血清钠（mmol/L）	136.2±6.9	137.4±5.4	0.442	0.644
血清钙（mmol/L）	2.1±0.1	2.2±0.1	1.761	0.081
FEV₁%	58.8±21.9	52.7±17.5	1.840	0.680
FVC%	83.4±21.2	81.9±18.6	0.446	0.656
FEV₁/FVC（%）	54.8±11.1	50.4±10.2	2.465	0.150
GOLD 1级[n（%）]	4（6.7）	1（3.1）	0.517	0.772
GOLD 2级[n（%）]	54（90）	30（93.8）
GOLD 3级[n（%）]	2（3.3）	1（3.1）
LABA/LAMA[n（%）]	10（16.7）	3（9.4）	1.571	0.456
ICS/LABA[n（%）]	46（76.7）	28（87.5）
ICS/LABA/LAMA[n（%）]	4（6.7）	1（3.1）
BMI（kg/m²）	25.4±3.0	20.2±2.2	8.853	0.006
ASM（kg）	23.4±2.5	18.7±2.5	14.846	0.005
SMI（kg/m²）	8.0±0.6	5.6±0.5	17.868	0.004
握力（kg）	29.7±3.0	21.0±5.4	9.638	0.006
mMRC评分（分）	0.9±0.7	1.4±1.0	8.729	0.013
CAT评分（分）	8.4±4.3	11.7±4.4	5.131	0.008
6 m步速（m/s）	1.1±0.2	0.7±0.2	4.286	0.006

指标	FEV₁%		FVC%		FEV₁/FVC		mMRC		CAT		6 m步速
指标	r	P	r	P	r	P	r	P	r	P	r	P
非肌少症组
BMI	0.376	0.031	0.894	0.388	0.056	0.716	-0.340	0.032	-0.354	0.043	0.436	0.015
SMI	0.365	0.037	0.075	0.629	0.003	0.894	-0.262	0.023	-0.367	0.036	0.392	0.024
握力	0.094	0.541	0.056	0.716	0.293	0.110	-0.327	0.064	-0.316	0.073	0.319	0.071
肌少症组
BMI	0.257	0.026	0.619	0.071	0.225	0.162	-0.293	0.010	-0.306	0.004	0.93	0.001
SMI	0.696	0.004	0.193	0.199	0.760	0.002	-0.645	0.002	-0.594	0.003	0.86	0.002
握力	0.343	0.020	0.541	0.438	0.359	0.040	-0.524	0.003	-0.571	0.018	0.329	0.062

因素	mMRC			CAT			6 m步速
因素	OR	95%CI	P	OR	95%CI	P	OR	95%CI	P
年龄	0.973	0.869，1.092	0.726	0.978	0.870，1.102	0.691	0.914	0.831，1.062	0.738
血红蛋白	1.117	0.512，2.438	0.783	0.991	0.915，1.097	0.527	1.015	0.485，1.629	0.503
白蛋白	1.146	0.899，1.303	0.095	1.133	0.882，1.324	0.101	1.193	0.953，1.997	0.072
FEV₁	0.971	0.862，1.086	0.874	0.984	0.857，1.121	0.933	1.077	0.857，1.592	0.394
FVC%	0.936	0.829，1.341	0.939	0.949	0.856，1.381	0.273	1.136	0.931，2.018	0.483
FEV₁/FVC	0.201	0.006，4.329	0.302	0.198	0.007，4.297	0.192	1.094	0.873，1.615	0.442
BMI	0.316	0.061，1.172	0.109	0.526	0.091，1.212	0.825	3.875	1.973，5.148	0.017
握力	1.501	0.919，2.433	0.121	1.442	0.927，2.252	0.098	1.069	0.775，1.865	0.089
SMI	0.169	0.066，0.479	0.002	0.173	0.059，0.437	0.002	4.017	2.174，5.992	0.011