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      Sarcopenia as an Independent Risk Factor for Decreased BMD in COPD Patients: Korean National Health and Nutrition Examination Surveys IV and V (2008-2011)

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          Abstract

          Background

          A decrease in bone mineral density (BMD) is a systemic consequence of chronic obstructive pulmonary disease (COPD). Past reports have rarely examined any correlation between sarcopenia and BMD. We investigated the relationship cross-sectionally between the presence of sarcopenia and BMD reduction in COPD patients.

          Methods

          COPD patients aged 50 or older with qualifying spirometry and dual-energy X-ray absorptiometry data were from participants in the Korean National Health and Nutrition Examination Surveys IV and V (2008–2011).

          Results

          There were 286 (33.3%) subjects in the sarcopenia group and 572 (66.7%) in the non-sarcopenia group. The sarcopenia group had lower T-scores than the non-sarcopenia group (femur: -0.73±0.88 vs. -0.18±0.97, p < 0.001; femur neck: -1.44±0.98 vs. -0.99±1.06, p < 0.001; lumbar: -1.38±1.36 vs. -0.84±1.38, p < 0.001). The prevalences of osteopenia and osteoporosis were 60.8% and 22.0%, respectively, in the sarcopenia group and 45.6% and 13.3% in the non-sarcopenia group (both p < 0.001). After adjusting for multiple variables, the presence of sarcopenia associated with increased the risk of osteopenia, osteoporosis, and a low BMD (OR = 3.227, 95% CI = 2.125–4.899, p < 0.001, OR = 6.952, 95% CI = 3.418–14.139, p < 0.001, and OR = 3.495, 95% CI = 2.315–5.278, p < 0.001, respectively). In a subgroup analysis, similar OR changes were confirmed in the high-body-weight group ( n = 493) (OR = 2.248, 95% CI = 1.084–4.665, p = 0.030, OR = 4.621, 95% CI = 1.167–18.291, p = 0.029, and OR = 2.376, 95% CI = 1.158–4.877, p = 0.018, respectively).

          Conclusions

          The presence of sarcopenia was associated with increased the risk for decreased BMD in COPD.

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          Most cited references21

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          Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study

          The Lancet, 349(9064), 1498-1504
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            • Record: found
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            Mortality in COPD: Role of comorbidities.

            Chronic obstructive pulmonary disease (COPD) represents an increasing burden throughout the world. COPD-related mortality is probably underestimated because of the difficulties associated with identifying the precise cause of death. Respiratory failure is considered the major cause of death in advanced COPD. Comorbidities such as cardiovascular disease and lung cancer are also major causes and, in mild-to-moderate COPD, are the leading causes of mortality. The links between COPD and these conditions are not fully understood. However, a link through the inflammation pathway has been suggested, as persistent low-grade pulmonary and systemic inflammation, both known risk factors for cardiovascular disease and cancer, are present in COPD independent of cigarette smoking. Lung-specific measurements, such as forced expiratory volume in one second (FEV(1)), predict mortality in COPD and in the general population. However, composite tools, such as health-status measurements (e.g. St George's Respiratory Questionnaire) and the BODE index, which incorporates Body mass index, lung function (airflow Obstruction), Dyspnoea and Exercise capacity, predict mortality better than FEV(1) alone. These multidimensional tools may be more valuable because, unlike predictive approaches based on single parameters, they can reflect the range of comorbidities and the complexity of underlying mechanisms associated with COPD. The current paper reviews the role of comorbidities in chronic obstructive pulmonary disease mortality, the putative underlying pathogenic link between chronic obstructive pulmonary disease and comorbid conditions (i.e. inflammation), and the tools used to predict chronic obstructive pulmonary disease mortality.
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              • Record: found
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              • Article: not found

              Chronic obstructive pulmonary disease.

              P Barnes (2000)
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                17 October 2016
                2016
                : 11
                : 10
                : e0164303
                Affiliations
                [1 ]Division of Pulmonology, Department of Internal Medicine, Andong Sungso Hospital, Andong, Korea
                [2 ]Division of Pulmonology and Allergy, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea
                University of Nevada Las Vegas, UNITED STATES
                Author notes

                Competing Interests: The authors declare that they have no competing interests.

                • Conceptualization: DWL.

                • Data curation: DWL EYC.

                • Formal analysis: DWL EYC.

                • Investigation: DWL.

                • Methodology: DWL.

                • Project administration: EYC.

                • Resources: DWL.

                • Software: DWL.

                • Supervision: EYC.

                • Validation: EYC.

                • Visualization: EYC.

                • Writing – original draft: DWL.

                • Writing – review & editing: EYC.

                Article
                PONE-D-16-08507
                10.1371/journal.pone.0164303
                5066961
                27749901
                e2e9c32c-113b-4744-99bf-7f28219cf979
                © 2016 Lee, Choi

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 1 March 2016
                : 22 September 2016
                Page count
                Figures: 2, Tables: 7, Pages: 13
                Funding
                This work was supported by the YUMC Regional Center for Respiratory diseases research grant.
                Categories
                Research Article
                Medicine and Health Sciences
                Diagnostic Medicine
                Signs and Symptoms
                Sarcopenia
                Medicine and Health Sciences
                Pathology and Laboratory Medicine
                Signs and Symptoms
                Sarcopenia
                Medicine and Health Sciences
                Pulmonology
                Chronic Obstructive Pulmonary Disease
                Medicine and Health Sciences
                Women's Health
                Osteopenia and Osteoporosis
                Medicine and Health Sciences
                Rheumatology
                Connective Tissue Diseases
                Osteoporosis
                Biology and Life Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Medicine and Health Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Biology and Life Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Body Mass Index
                Medicine and Health Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Body Mass Index
                Biology and Life Sciences
                Biochemistry
                Hormones
                Parathyroid Hormone
                Physical sciences
                Chemistry
                Chemical compounds
                Organic compounds
                Vitamins
                Vitamin D
                Physical sciences
                Chemistry
                Organic chemistry
                Organic compounds
                Vitamins
                Vitamin D
                Custom metadata
                Data cannot be made publicly available to protect patient privacy. Data are available upon request from the corresponding authors.

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                Uncategorized

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