Fat-Free Mass Index and functional limitation in COPD

Abstract

<b>Introduction:</b> Malnutrition is one of the most important factors that lead to lower quality of life in patients suffering from chronic obstructive pulmonary disease (COPD). Low Fat-Free Mass Index (FFMI) has been associated with increased mortality in severe COPD. The impact of body composition earlier in the disease remains unclear. We studied the impact of body composition on the risk of functional limitation in COPD. <b>Methods:</b> This cross-sectional study conducted over 12 months, including patients with stable COPD. Bioelectrical impedance analysis was performed to determine lean body mass. Fat-free mass index (FFMI) was calculated according to fat-free mass (FMM) (kg)/height (m)2. The study population was divided into two groups according to GOLD guidelines: 45 subjects with mild to moderate COPD (G1) and 35 subjects with severe to very severe COPD (G2). <b>Results:</b> Mean age (years) and mean body mass index (BMI) (kg/m2) were 63.86 ± 6.84 and 25.34 ± 5.04 respectively, with no significant difference between the two groups. FFMI (kg/m2) was significantly lower in G2 (G1: 19.29 ± 2.74 vs. G2: 17.49 ± 2.89; p&lt;0.01). In addition, a significant difference between the two groups was found in terms of Modified Medical Research Council (MMRC) dyspnea scale (G1: 1.66 ± 0.73 vs. G2: 2.67 ± 0.58; p &lt; 0.001). When correlating FFMI with lung function and dyspnea, we found that FFMI was significantly correlated with FEV1% (p = 0.001; r = 0.357) and MMRC dyspnea scale (p &lt; 0.001; r = -0.65). <b>Conclusion:</b> A low FFMI may partly explain the severity of COPD as a multisystemic disease.