Sarcopenia in COPD patients (43% prevalence) was associated with reduced arm and leg lean mass (p<0.001) and greater functional impairment in the legs as measured by phase angle (p≤0.001).
Observational (n=160)
In COPD patients with sarcopenia, arms show greater proportional muscle mass loss while legs exhibit more pronounced functional impairment, highlighting the need for comprehensive upper and lower extremity strength training.
p-value: p=<0.001
Abstract Background Sarcopenia (skeletal muscle loss) is common in COPD and a significant contributor to adverse clinical outcomes. However, sarcopenia is not routinely screened for or treated in COPD patients. For patients with sarcopenia, treatment strategies include optimization of medical therapy, improving nutrition, and increasing physical activity. We hypothesized that a subspecialty clinic could diagnose and treat sarcopenia due to COPD. Design COPD patients (n = 160) with concern for sarcopenia were referred to a subspecialty clinic between September 2024-September 2025. As a part of routine care in the clinic, COPD patients underwent bio-impedance analysis (BIA) to determine body composition. Sarcopenia was defined by low skeletal muscle index (SMI): 7.0 kg/m2 for males and 5.5 kg/m2 for females as previously described (PMID: 30312372). We compared body composition measures by student’s t test and chi square test for continuous and categorical variables, respectively. Results Of the patients evaluated, 69 (43%) met criteria for sarcopenia by bio-impedance, which is consistent with our previous analysis quantifying sarcopenia based on pectoralis muscle mass. Mean BMI was ∼32% lower for those with sarcopenia versus non-sarcopenic (18.5 vs. 27.1 kg/m², p 0.001). Adiposity measures were also lower in sarcopenia, with lower percent body fat (25.0% vs. 35.2%, p 0.001) visceral fat area (70 vs. 149 cm², p 0.001), and smaller mid-arm circumference (10.0 vs. 12.9 in, p 0.001). Among participants with sarcopenia, both arm and leg muscle mass were significantly reduced compared to those without sarcopenia. Arm lean mass was reduced from 5.86 kg to 3.74 kg in the right arm and from 5.62 kg to 3.67 kg in the left arm (p 0.001). Similarly, leg lean mass was reduced from 16.20 kg to 12.13 kg in the right leg and from 16.06 kg to 12.20 kg in the left leg (p 0.001). However, the phase angle, a measure of cellular integrity and muscle quality, showed a greater reduction in the legs compared to the arms, with right leg values decreased from 3.79 to 3.35 and left leg from 3.79 to 3.31 (p ≤ 0.001). These findings suggest that while both regions experience substantial muscle loss, the legs demonstrate more pronounced impairment in functional muscle quality. Conclusion When comparing arm and leg lean mass, we found that the arms showed greater proportional muscle mass loss, but the legs exhibited more pronounced functional impairment. Our findings highlight the importance of emphasizing both upper-extremity and lower-extremity strength training in COPD patients with sarcopenia. This abstract is funded by: CCF HDISC Implementation
Attaway et al. (Fri,) conducted a observational in COPD-associated Sarcopenia (n=160). Sarcopenia vs. Non-sarcopenic COPD patients was evaluated on Body composition measures (BMI, adiposity, arm/leg muscle mass) and phase angle (p=<0.001). Sarcopenia in COPD patients (43% prevalence) was associated with reduced arm and leg lean mass (p<0.001) and greater functional impairment in the legs as measured by phase angle (p≤0.001).