Background

The phenotype profiling of individuals with chronic obstructive pulmonary disease (COPD) according to impairments in body composition and level of physical activity in daily life (PADL) needs to be determined.

Objective

To verify if individuals with COPD classified as physically active/inactive present different characteristics within different body composition phenotypes.

Methods

Individuals with COPD were cross-sectionally stratified into four groups according to fat-free and fat mass indexes: Normal Body Composition (NBC), Obese (Ob), Sarcopenic (Sarc), and Sarcopenic/Obese (Sarc/Ob). Additionally, individuals had their PADL level objectively assessed through activity monitoring during two weekdays for at least 10 h/day, and then were classified as physically active (Act) or inactive (Inact) according to international recommendations. Lung function (spirometry), exercise capacity (6-minute walking test [6MWT]) and peripheral muscle strength (1-repetition maximum [1RM]) were also assessed.

Results

176 individuals with COPD (mean ± standard deviation age: 67 ± 8 years, body mass index 26 ± 6 kg/m², FEV1 47 ± 16%predicted) were classified as: NBC + Act (17%), NBC + Inact (22%), Ob + Act (6%), Ob + Inact (10%), Sarc + Act (12%), Sarc + Inact (9%), Sarc/Ob + Act (8%) and Sarc/Ob + Inact (16%). The Sarc/Ob + Inact group presented lower 6MWT and 1RM for knee extension compared to NBC + Act, NBC + Inact, and Ob + Act groups (p < 0.05). The Sarc/Ob + Inact group also presented lower FEV1% predicted, 1RM for elbow flexion and elbow extension compared to the NBC + Act and NBC + Inact groups and lower 1RM for elbow extension compared to Ob + Inact group (p < 0.05).

Conclusion

The combination of sarcopenia, obesity, and physical inactivity was shown to be detrimental in individuals with COPD. Therefore, this profile is a main therapeutic target for improving PADL level and/or body composition.

中文翻译：

---

中度至极重度慢性阻塞性肺疾病患者不同身体成分表型的身体活动和不活动

背景

需要根据身体成分和日常生活中的体力活动水平 (PADL) 对慢性阻塞性肺病 (COPD) 患者进行表型分析。

客观的

验证被归类为身体活跃/不活跃的 COPD 个体是否在不同的身体成分表型中呈现不同的特征。

方法

根据无脂肪和脂肪质量指数将 COPD 患者横断面分为四组：正常身体成分 (NBC)、肥胖 (Ob)、肌肉减少症 (Sarc) 和肌肉减少症/肥胖 (Sarc/Ob)。此外，通过在两个工作 日内至少 10小时/天的活动监测客观评估个人的 PADL 水平，然后根据国际建议将其分为身体活跃 (Act) 或不活跃 (Inact)。还评估了肺功能（肺活量测定法）、运动能力（6 分钟步行试验 [6MWT]）和外周肌肉力量（1 次重复最大值 [1RM]）。

结果

176 名 COPD 患者（平均 ± 标准偏差年龄：67  ±  8 岁，体重指数 26  ±  6  kg/m ²，FEV1 47  ±  16% 预测）被分类为：NBC  +  Act (17%)、NBC  +  Inact ( 22%)、Ob  +  Act (6%)、Ob  +  Inact (10%)、Sarc  +  Act (12%)、Sarc  +  Inact (9%)、Sarc/Ob  +  Act (8%) 和 Sarc/Ob  + 不活动 (16%)。与 NBC + Act、NBC + Inact 和 Ob +相比，Sarc /Ob  +  Inact 组膝关节伸展的 6MWT 和 1RM 较低      行动组 ( p  <  0.05)。与 NBC + Act 和 NBC + Inact 组相比，Sarc /Ob  +  Inact 组的预测 FEV1% 也较低，肘部屈曲和肘部伸展为1RM，与 Ob + Inact 组相比，肘部伸展为 1RM （p < 0.05）。        

结论

肌肉减少症、肥胖症和缺乏身体活动的组合对 COPD 患者有害。因此，该特征是改善 PADL 水平和/或身体成分的主要治疗目标。