Abstract
Background: Differences in body composition are extensively investigated in subjects with COPD as low muscle mass was independently associated with increased morbidity and mortality. Also cardio-vascular co-morbidity is often reported in COPD and the contribution of fat mass in COPD related co-morbidity is gaining interest. We hypothesized that the prevalence of low muscle mass and high fat mass is higher in subjects with COPD compared to a group of current and former smokers without COPD, which result in higher reported cardiovascular co-morbidity in the COPD group. Methods: In 954 subjects with COPD and 955 subjects without COPD, body composition was assessed by bio-electrical impedance analysis and information on self-reported co-morbidity was collected. Participants were stratified for low fat free mass index and high fat mass index (resp. fat free mass index 50th percentile of the subjects without COPD). Results: Subjects with COPD were more likely to have low fat free mass index than current and former smokers without COPD. The prevalence of high fat mass index was comparable between the groups. The percentage of self-reported co-morbidity was higher in subjects with COPD, but only reports of myocardial infarction were disease specific. Conclusion: Low fat free mass index was more common in COPD, but the prevalence of high fat mass index was comparable between subjects with and without COPD. Nevertheless, subjects with COPD reported more myocardial infarction, implying that other factors than the amount of fat mass are involved in the increased co-morbidity in COPD.
Highlights
It is currently accepted that COPD is a heterogeneous disease with a high prevalence of co-morbidity such as cardiovascular disease and diabetes mellitus type II [1,2]
The present study confirms that low FFMI is more prevalent in a large group of subjects with moderate to severe COPD when compared to current and former smokers without COPD, independent of sex and age
The prevalence of low FFMI is higher in women with COPD compared to men with COPD
Summary
It is currently accepted that COPD is a heterogeneous disease with a high prevalence of co-morbidity such as cardiovascular disease and diabetes mellitus type II [1,2]. It is believed that the prevalence of low muscle mass is higher in subjects with COPD compared to healthy age matched subjects, but corroborating research is limited. Recently, it is shown from the Health ABC study that the lean mass in subjects with obstructive lung disease was lower compared to formerly and never smoking controls, but was not different than current smoking controls [7]. Body composition and reports of cardiovascular co-morbidities and diabetes mellitus type II were measured in a large cohort of subjects with COPD and a cohort of current and former smokers without COPD. The prevalence of high fat mass index is defined as a fat mass index (FMI, fat mass/length2) that is more than 50% of the control population, and was associated with the percentage of self-reported co-morbidity
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