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Erschienen in: Endocrine 1/2018

05.02.2018 | Original Article

Body composition and sarcopenia in patients with chronic obstructive pulmonary disease

verfasst von: Tatiana Munhoz da Rocha Lemos Costa, Fabio Marcelo Costa, Thaísa Hoffman Jonasson, Carolina Aguiar Moreira, César Luiz Boguszewski, Victória Zeghbi Cochenski Borba

Erschienen in: Endocrine | Ausgabe 1/2018

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Abstract

Purpose

Changes in body composition are commonly present in chronic obstructive pulmonary disease (COPD). The main aim of this study were to evaluate changes in body composition and the prevalence of pre-sarcopenia and sarcopenia in patients with COPD, compared with two control groups and correlate these parameters with indices of COPD severity (VEF1 and GOLD) and prognosis (BODE).

Methods

This was a cross-sectional study in COPD patients (DG) that undergone body composition assessment by DXA. Two control groups were used, smokers individuals without COPD (smokers group, SG), and healthy never smokers individuals (never smokers group, NSG).

Results

DG comprised 121 patients (65 women, mean age 67.9 ± 8.6 years). The percentage of total body fat mass (TFM) was significantly lower in DG in both genders, despite no difference in BMI. Both BMI and relative skeletal muscle mass index (RSMI) decreased according to the worsening of GOLD in men and women, as well as the TFM and total lean mass (TLM) in men. As BODE get worse, BMI and RSMI decreased in both sexes, as well as TLM in men. The prevalence of pre-sarcopenia in the DG was 46.3% and no different with controls. In DG 12.4% were sarcopenic. Patients with sarcopenia were older and had worse prognosis. Higher BODE prognostic index, higher the prevalence of sarcopenia (OR 3.5, 95% CI 1.06–11.56, p = 0.035).

Conclusions

This study showed alterations in body composition parameters in patients with COPD. A high prevalence of sarcopenia and the association with worse prognostic index.
Literatur
1.
Zurück zum Zitat Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease. National Heart, Lung and Blood Institutes. (2011). www.goldcopd.com Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease. National Heart, Lung and Blood Institutes. (2011). www.​goldcopd.​com
2.
Zurück zum Zitat T.M. Eagan, P. Aukrust, T. Ueland, J.A. Hardie, A. Johannessen, T.E. Mollnes et al. Body composition and plasma levels of inflammatory biomarkers in COPD. Eur. Respir. J. 36(5), 1027–1033 (2010)CrossRefPubMed T.M. Eagan, P. Aukrust, T. Ueland, J.A. Hardie, A. Johannessen, T.E. Mollnes et al. Body composition and plasma levels of inflammatory biomarkers in COPD. Eur. Respir. J. 36(5), 1027–1033 (2010)CrossRefPubMed
3.
4.
Zurück zum Zitat M. Decramer, W. Janssens, M. Miravitlles, Chronic obstructive pulmonary disease. Lancet 379(9823), 1341–1351 (2012).CrossRefPubMed M. Decramer, W. Janssens, M. Miravitlles, Chronic obstructive pulmonary disease. Lancet 379(9823), 1341–1351 (2012).CrossRefPubMed
5.
Zurück zum Zitat M.I. Polkey, J. Moxham, Attacking the disease spiral in chronic obstructive pulmonary disease. Clin. Med. 6(2), 190–196 (2006)CrossRef M.I. Polkey, J. Moxham, Attacking the disease spiral in chronic obstructive pulmonary disease. Clin. Med. 6(2), 190–196 (2006)CrossRef
6.
Zurück zum Zitat P. Tunsupon, M.J. Mador, The influence of body composition on pulmonary rehabilitation outcomes in chronic obstructive pulmonary disease patients. Lung 195(6), 729–738 (2017).CrossRefPubMed P. Tunsupon, M.J. Mador, The influence of body composition on pulmonary rehabilitation outcomes in chronic obstructive pulmonary disease patients. Lung 195(6), 729–738 (2017).CrossRefPubMed
7.
Zurück zum Zitat A.J. Cruz-Jentoft, F. Landi, S.M. Schneider, C. Zúñiga, H. Arai, Y. Boirie, L.K. Chen, R.A. Fielding, F.C. Martin, J.P. Michel, C. Sieber, J.R. Stout, S.A. Studenski, B. Vellas, J. Woo, M. Zamboni, T. Cederholm, Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS). Age Ageing 43(6), 748–759 (2014)CrossRefPubMedPubMedCentral A.J. Cruz-Jentoft, F. Landi, S.M. Schneider, C. Zúñiga, H. Arai, Y. Boirie, L.K. Chen, R.A. Fielding, F.C. Martin, J.P. Michel, C. Sieber, J.R. Stout, S.A. Studenski, B. Vellas, J. Woo, M. Zamboni, T. Cederholm, Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS). Age Ageing 43(6), 748–759 (2014)CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat M.K. Byun, E.N. Cho, J. Chang, C.M. Ahn, H.J. Kim, Sarcopenia correlates with systemic inflammation in COPD. Int. J. Chron. Obstruct. Pulmon. Dis. 12, 669–675 (2017)CrossRefPubMedPubMedCentral M.K. Byun, E.N. Cho, J. Chang, C.M. Ahn, H.J. Kim, Sarcopenia correlates with systemic inflammation in COPD. Int. J. Chron. Obstruct. Pulmon. Dis. 12, 669–675 (2017)CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat S.E. Jones, M. Maddocks, S.S. Kon, J.L. Canavan, C.M. Nolan, A.L. Clark, M.I. Polkey, W.D. Man, Sarcopenia in COPD: prevalence, clinical correlates and response to pulmonary rehabilitation. Thorax 70(3), 213–218 (2015)CrossRefPubMed S.E. Jones, M. Maddocks, S.S. Kon, J.L. Canavan, C.M. Nolan, A.L. Clark, M.I. Polkey, W.D. Man, Sarcopenia in COPD: prevalence, clinical correlates and response to pulmonary rehabilitation. Thorax 70(3), 213–218 (2015)CrossRefPubMed
10.
Zurück zum Zitat C.B. Franco, G. Paz-Filho, P.E. Gomes, V.B. Nascimento, C.A. Kulak, C.L. Boguszewski, V.Z. Borba, Chronic obstructive pulmonary disease is associated with osteoporosis and low levels of vitamin D. Osteoporos. Int. 20(11), 1881–1887 (2009)CrossRefPubMed C.B. Franco, G. Paz-Filho, P.E. Gomes, V.B. Nascimento, C.A. Kulak, C.L. Boguszewski, V.Z. Borba, Chronic obstructive pulmonary disease is associated with osteoporosis and low levels of vitamin D. Osteoporos. Int. 20(11), 1881–1887 (2009)CrossRefPubMed
11.
Zurück zum Zitat L. Graat-Verboom, E.F. Wouters, F.W. Smeenk, B.E. van den Borne, R. Lunde, M.A. Spruit, Current status of research on osteoporosis in COPD: a systematic review. Eur. Respir. J. 34, 209–218 (2009)CrossRefPubMed L. Graat-Verboom, E.F. Wouters, F.W. Smeenk, B.E. van den Borne, R. Lunde, M.A. Spruit, Current status of research on osteoporosis in COPD: a systematic review. Eur. Respir. J. 34, 209–218 (2009)CrossRefPubMed
12.
Zurück zum Zitat Y. Yamamoto, M. Yoshikawa, K. Tomoda, Y. Fujita, M. Yamauchi, A. Fukuoka, S. Tamaki, N. Koyama, H. Kimura, Distribution of bone mineral content is associated with body weight and exercise capacity in patients with chronic obstructive pulmonary disease. Respiration 87(2), 158–164 (2014)CrossRefPubMed Y. Yamamoto, M. Yoshikawa, K. Tomoda, Y. Fujita, M. Yamauchi, A. Fukuoka, S. Tamaki, N. Koyama, H. Kimura, Distribution of bone mineral content is associated with body weight and exercise capacity in patients with chronic obstructive pulmonary disease. Respiration 87(2), 158–164 (2014)CrossRefPubMed
13.
Zurück zum Zitat W. Janssens, A. Lehouck, C. Carremans, R. Bouillon, C. Mathieu, M. Decramer, Vitamin D beyond bones in chronic obstructive pulmonary disease: time to act. Am. J. Respir. Crit. Care Med. 179, 630–636 (2009)CrossRefPubMed W. Janssens, A. Lehouck, C. Carremans, R. Bouillon, C. Mathieu, M. Decramer, Vitamin D beyond bones in chronic obstructive pulmonary disease: time to act. Am. J. Respir. Crit. Care Med. 179, 630–636 (2009)CrossRefPubMed
14.
Zurück zum Zitat L. Forli, O.J. Mellbye, J. Halse, O. Bjortuft, M. Vatn, J. Boe, Cytokines, bone turnover markers and weight change in candidates for lung transplantation. Pulm. Pharmacol. Ther. 21, 188–195 (2008)CrossRefPubMed L. Forli, O.J. Mellbye, J. Halse, O. Bjortuft, M. Vatn, J. Boe, Cytokines, bone turnover markers and weight change in candidates for lung transplantation. Pulm. Pharmacol. Ther. 21, 188–195 (2008)CrossRefPubMed
15.
Zurück zum Zitat H.K. Koo, J.H. Park, H.K. Park, H. Jung, S.S. Lee, Conflicting role of sarcopenia and obesity in male patients with chronic obstructive pulmonary disease: Korean National Health and Nutrition Examination Survey. PLoS. One 9(10), e110448 (2014)CrossRefPubMedPubMedCentral H.K. Koo, J.H. Park, H.K. Park, H. Jung, S.S. Lee, Conflicting role of sarcopenia and obesity in male patients with chronic obstructive pulmonary disease: Korean National Health and Nutrition Examination Survey. PLoS. One 9(10), e110448 (2014)CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat D.A. Lipschitz, Screening for nutritional status in the elderly. Prim. Care 21(1), 55–67 (1994)PubMed D.A. Lipschitz, Screening for nutritional status in the elderly. Prim. Care 21(1), 55–67 (1994)PubMed
17.
Zurück zum Zitat S.A. Studenski, K.W. Peters, D.E. Alley, P.M. Cawthon, R.R. McLean, T.B. Harris, L. Ferrucci, J.M. Guralnik, M.S. Fragala, A.M. Kenny, D.P. Kiel, S.B. Kritchevsky, M.D. Shardell, T.T. Dam, M.T. Vassileva, The FNIH sarcopenia project: rationale, study description,conference recommendations, and final estimates. J. Gerontol. Ser. A 69(5), 547–558 (2014)CrossRef S.A. Studenski, K.W. Peters, D.E. Alley, P.M. Cawthon, R.R. McLean, T.B. Harris, L. Ferrucci, J.M. Guralnik, M.S. Fragala, A.M. Kenny, D.P. Kiel, S.B. Kritchevsky, M.D. Shardell, T.T. Dam, M.T. Vassileva, The FNIH sarcopenia project: rationale, study description,conference recommendations, and final estimates. J. Gerontol. Ser. A 69(5), 547–558 (2014)CrossRef
18.
Zurück zum Zitat J. Prignot, Quantification and chemical markers of tobacco-exposure. Eur. J. Respir. Dis. 70(1), 1–7 (1987)PubMed J. Prignot, Quantification and chemical markers of tobacco-exposure. Eur. J. Respir. Dis. 70(1), 1–7 (1987)PubMed
19.
Zurück zum Zitat B.G. Ferris, Epidemiology standardization project (American Thoracic Society). Am. Rev. Respir. Dis. 118(6 Pt 2), 1–120 (1978)PubMed B.G. Ferris, Epidemiology standardization project (American Thoracic Society). Am. Rev. Respir. Dis. 118(6 Pt 2), 1–120 (1978)PubMed
20.
Zurück zum Zitat P.W. Jones, G. Harding, P. Berry et al. Development and first validation of the COPD assessment test. Eur. Respir. J. 34(3), 648–654 (2009)CrossRefPubMed P.W. Jones, G. Harding, P. Berry et al. Development and first validation of the COPD assessment test. Eur. Respir. J. 34(3), 648–654 (2009)CrossRefPubMed
21.
Zurück zum Zitat B. Balke, A simple field test for the assessment of physical fitness. Rep 63–6. Rep Civ Aeromed Res Inst US. 1–8 (1963) B. Balke, A simple field test for the assessment of physical fitness. Rep 63–6. Rep Civ Aeromed Res Inst US. 1–8 (1963)
22.
Zurück zum Zitat B. Celli, C. Cote, J. Marin et al. The body mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N. Engl. J. Med. 350, 1005–1012 (2004)CrossRefPubMed B. Celli, C. Cote, J. Marin et al. The body mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N. Engl. J. Med. 350, 1005–1012 (2004)CrossRefPubMed
23.
Zurück zum Zitat D.A. Stern, W.J. Morgan, A.L. Wright, S. Guerra, F.D. Martinez, Poor airway function in early infancy and lung function by age 22 years: a non-selective longitudinal cohort study. Lancet 370(9589), 758–764 (2007)CrossRefPubMedPubMedCentral D.A. Stern, W.J. Morgan, A.L. Wright, S. Guerra, F.D. Martinez, Poor airway function in early infancy and lung function by age 22 years: a non-selective longitudinal cohort study. Lancet 370(9589), 758–764 (2007)CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat G.M. Hunninghake, M.H. Cho, Y. Tesfaigzi, M.E. Soto-Quiros, L. Avila, J. Lasky-Su, C. Stidley, E. Melén, C. Söderhäll, J. Hallberg, I. Kull, J. Kere, M. Svartengren, G. Pershagen, M. Wickman, C. Lange, D.L. Demeo, C.P. Hersh, B.J. Klanderman, B.A. Raby, D. Sparrow, S.D. Shapiro, E.K. Silverman, A.A. Litonjua, S.T. Weiss, J.C. Celedón, MMP12, lung function, and COPD in high-risk populations. N. Engl. J. Med. 361(27), 2599–2608 (2009)CrossRefPubMedPubMedCentral G.M. Hunninghake, M.H. Cho, Y. Tesfaigzi, M.E. Soto-Quiros, L. Avila, J. Lasky-Su, C. Stidley, E. Melén, C. Söderhäll, J. Hallberg, I. Kull, J. Kere, M. Svartengren, G. Pershagen, M. Wickman, C. Lange, D.L. Demeo, C.P. Hersh, B.J. Klanderman, B.A. Raby, D. Sparrow, S.D. Shapiro, E.K. Silverman, A.A. Litonjua, S.T. Weiss, J.C. Celedón, MMP12, lung function, and COPD in high-risk populations. N. Engl. J. Med. 361(27), 2599–2608 (2009)CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat A.E. Makarevich, S. Lemiasheuskaya, Dynamics of body composition in male patients during chronic obstructive pulmonary disease (COPD) development. Pneumonol. Alergol. Pol. 83(6), 424–430 (2015)CrossRefPubMed A.E. Makarevich, S. Lemiasheuskaya, Dynamics of body composition in male patients during chronic obstructive pulmonary disease (COPD) development. Pneumonol. Alergol. Pol. 83(6), 424–430 (2015)CrossRefPubMed
26.
Zurück zum Zitat S.B. Kim, Y.A. Kang, J.Y. Jung, M.S. Park, Y.S. Kim, S.K. Kim, J. Chang, E.Y. Kim, Body mass index and fat free mass index in obstructive lung disease in Korea. Int. J. Tuberc. Lung Dis. 18(1), 102–108 (2014)CrossRefPubMed S.B. Kim, Y.A. Kang, J.Y. Jung, M.S. Park, Y.S. Kim, S.K. Kim, J. Chang, E.Y. Kim, Body mass index and fat free mass index in obstructive lung disease in Korea. Int. J. Tuberc. Lung Dis. 18(1), 102–108 (2014)CrossRefPubMed
27.
Zurück zum Zitat M. Lainscak, S. von Haehling, W. Doehner, I. Sarc, T. Jeric, K. Ziherl, M. Kosnik, S.D. Anker, S. Suskovic, Body mass index and prognosis in patients hospitalized with acute exacerbation of chronic obstructive pulmonary disease. J. Cachex-. Sarcopenia Muscle 2(2), 81–86 (2011)CrossRef M. Lainscak, S. von Haehling, W. Doehner, I. Sarc, T. Jeric, K. Ziherl, M. Kosnik, S.D. Anker, S. Suskovic, Body mass index and prognosis in patients hospitalized with acute exacerbation of chronic obstructive pulmonary disease. J. Cachex-. Sarcopenia Muscle 2(2), 81–86 (2011)CrossRef
28.
Zurück zum Zitat N.S. Hopkinson, R.C. Tennant, M.J. Dayer, E.B. Swallow, T.T. Hansel, J. Moxham, M.I. Polkey, A prospective study of decline in fat free mass and skeletal muscle strength in chronic obstructive pulmonary disease. Respir. Res. 8, 25 (2007)CrossRefPubMedPubMedCentral N.S. Hopkinson, R.C. Tennant, M.J. Dayer, E.B. Swallow, T.T. Hansel, J. Moxham, M.I. Polkey, A prospective study of decline in fat free mass and skeletal muscle strength in chronic obstructive pulmonary disease. Respir. Res. 8, 25 (2007)CrossRefPubMedPubMedCentral
29.
Zurück zum Zitat B. Van den Borst, H.R. Gosker, A.M. Schols, Central fat and peripheral muscle: partners in crime in chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 187(1), 8–13 (2013)CrossRefPubMed B. Van den Borst, H.R. Gosker, A.M. Schols, Central fat and peripheral muscle: partners in crime in chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 187(1), 8–13 (2013)CrossRefPubMed
30.
Zurück zum Zitat A.M. Abbatecola, A. Fumagalli, L. Spazzafumo, V. Betti, C. Misuraca, A. Corsonello, A. Cherubini, E.E. Guffanti, F. Lattanzio, Body composition markers in older persons with COPD. Age Ageing 43(4), 548–553 (2014)CrossRefPubMed A.M. Abbatecola, A. Fumagalli, L. Spazzafumo, V. Betti, C. Misuraca, A. Corsonello, A. Cherubini, E.E. Guffanti, F. Lattanzio, Body composition markers in older persons with COPD. Age Ageing 43(4), 548–553 (2014)CrossRefPubMed
31.
Zurück zum Zitat V. Andrianopoulos, E.F. Wouters, V.M. Pinto-Plata, L.E. Vanfleteren, P.S. Bakke, F.M. Franssen, A. Agusti, W. MacNee, S.I. Rennard, R. Tal-Singer, I. Vogiatzis, J. Vestbo, B.R. Celli, M.A. Spruit, Prognostic value of variables derived from the six-minute walk test in patients with COPD: Results from the ECLIPSE study. Respir. Med. 109(9), 1138–1146 (2015)CrossRefPubMed V. Andrianopoulos, E.F. Wouters, V.M. Pinto-Plata, L.E. Vanfleteren, P.S. Bakke, F.M. Franssen, A. Agusti, W. MacNee, S.I. Rennard, R. Tal-Singer, I. Vogiatzis, J. Vestbo, B.R. Celli, M.A. Spruit, Prognostic value of variables derived from the six-minute walk test in patients with COPD: Results from the ECLIPSE study. Respir. Med. 109(9), 1138–1146 (2015)CrossRefPubMed
32.
Zurück zum Zitat R.T. Jagoe, M.P. Engelen, Muscle wasting and changes in muscle protein metabolism in chronic obstructive pulmonary disease. Eur. Respir. J. 46, 52s–63s (2003)CrossRef R.T. Jagoe, M.P. Engelen, Muscle wasting and changes in muscle protein metabolism in chronic obstructive pulmonary disease. Eur. Respir. J. 46, 52s–63s (2003)CrossRef
33.
Zurück zum Zitat T.T. Dam, K.W. Peters, M. Fragala, P.M. Cawthon, T.B. Harris, R. McLean, M. Shardell, D.E. Alley, A. Kenny, L. Ferrucci, J. Guralnik, D.P. Kiel, S. Kritchevsky, M.T. Vassileva, S. Studenski, An evidence-based comparison of operational criteria for the presence of sarcopenia. J. Gerontol. Ser. A 69(5), 584–590 (2014)CrossRef T.T. Dam, K.W. Peters, M. Fragala, P.M. Cawthon, T.B. Harris, R. McLean, M. Shardell, D.E. Alley, A. Kenny, L. Ferrucci, J. Guralnik, D.P. Kiel, S. Kritchevsky, M.T. Vassileva, S. Studenski, An evidence-based comparison of operational criteria for the presence of sarcopenia. J. Gerontol. Ser. A 69(5), 584–590 (2014)CrossRef
34.
Zurück zum Zitat F.M. Franssen, H.P. Sauerwein, E.P. Rutten, E.F. Wouters, A.M. Schols, Whole-body resting and exercise-induced lipolysis in sarcopenic [corrected] patients with COPD. Eur. Respir. J. 32(6), 1466–1471 (2008)CrossRefPubMed F.M. Franssen, H.P. Sauerwein, E.P. Rutten, E.F. Wouters, A.M. Schols, Whole-body resting and exercise-induced lipolysis in sarcopenic [corrected] patients with COPD. Eur. Respir. J. 32(6), 1466–1471 (2008)CrossRefPubMed
35.
Zurück zum Zitat F. Maltais, Body composition in COPD: looking beyond BMI. Int. J. Tuberc. Lung. Dis. 18(1), 3–4 (2014)CrossRefPubMed F. Maltais, Body composition in COPD: looking beyond BMI. Int. J. Tuberc. Lung. Dis. 18(1), 3–4 (2014)CrossRefPubMed
36.
Zurück zum Zitat L.W. Lee, C.M. Lin, H.C. Li, P.L. Hsiao, A.C. Chung, C.J. Hsieh, P.C. Wu, S.F. Hsu, Body composition changes in male patients with chronic obstructive pulmonary disease: aging or disease process? PLoS. One 12(7), e0180928 (2017)CrossRefPubMedPubMedCentral L.W. Lee, C.M. Lin, H.C. Li, P.L. Hsiao, A.C. Chung, C.J. Hsieh, P.C. Wu, S.F. Hsu, Body composition changes in male patients with chronic obstructive pulmonary disease: aging or disease process? PLoS. One 12(7), e0180928 (2017)CrossRefPubMedPubMedCentral
37.
Zurück zum Zitat A.M. Schols, R. Broekhuizen, C.A. Weling-Scheepers, E.F. Wouters, Body composition and mortality in chronic obstructive pulmonary disease. Am. J. Clin. Nutr. 82(1), 53–59 (2005)CrossRefPubMed A.M. Schols, R. Broekhuizen, C.A. Weling-Scheepers, E.F. Wouters, Body composition and mortality in chronic obstructive pulmonary disease. Am. J. Clin. Nutr. 82(1), 53–59 (2005)CrossRefPubMed
38.
Zurück zum Zitat J.R. Guthrie, P.R. Ebeling, J.L. Hopper, E. Barrett-Connor, L. Dennerstein, E.C. Dudley, H.G. Burger, J.D. Wark, A prospective study of bone loss in menopausal Australian-born women. Osteoporos. Int. 8(3), 282–290 (1998)CrossRefPubMed J.R. Guthrie, P.R. Ebeling, J.L. Hopper, E. Barrett-Connor, L. Dennerstein, E.C. Dudley, H.G. Burger, J.D. Wark, A prospective study of bone loss in menopausal Australian-born women. Osteoporos. Int. 8(3), 282–290 (1998)CrossRefPubMed
39.
Zurück zum Zitat K. Zhu, M. Hunter, A. James, E.M. Lim, J.P. Walsh, Associations between body mass index, lean and fat body mass and bone mineral density in middle-aged Australians: The Busselton Healthy Ageing Study. Bone 74, 146–152 (2015)CrossRefPubMed K. Zhu, M. Hunter, A. James, E.M. Lim, J.P. Walsh, Associations between body mass index, lean and fat body mass and bone mineral density in middle-aged Australians: The Busselton Healthy Ageing Study. Bone 74, 146–152 (2015)CrossRefPubMed
40.
Zurück zum Zitat S.F. Vondracek, N.F. Voelkel, M.T. McDermott, C. Valdez, The relationship between adipokines, body composition, and bone density in men with chronic obstructive pulmonary disease. Int. J. Chron. Obstruct. Pulmon. Dis. 4, 267–277 (2009)CrossRefPubMedPubMedCentral S.F. Vondracek, N.F. Voelkel, M.T. McDermott, C. Valdez, The relationship between adipokines, body composition, and bone density in men with chronic obstructive pulmonary disease. Int. J. Chron. Obstruct. Pulmon. Dis. 4, 267–277 (2009)CrossRefPubMedPubMedCentral
Metadaten
Titel
Body composition and sarcopenia in patients with chronic obstructive pulmonary disease
verfasst von
Tatiana Munhoz da Rocha Lemos Costa
Fabio Marcelo Costa
Thaísa Hoffman Jonasson
Carolina Aguiar Moreira
César Luiz Boguszewski
Victória Zeghbi Cochenski Borba
Publikationsdatum
05.02.2018
Verlag
Springer US
Erschienen in
Endocrine / Ausgabe 1/2018
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-018-1533-4

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