COPD is associated with a progressive loss of muscle mass and function. However, there is an unmet need to define and standardise methods to estimate the prevalence of sarcopenia in COPD patients.We performed a systematic review and meta-analysis of the prevalence of this extrapulmonary manifestation in COPD patients. We searched Embase, Medline (Ovid), CINAHL (EBSCO), Web of Science, Scopus and Google Scholar for studies published up to January 17, 2019, assessing sarcopenia in COPD patients based on low muscle mass and decreased muscle function. Interventional studies, in vitro experiments, protocols or reviews and meta-analyses were excluded. We estimated heterogeneity (I2) and assessed significance (Q) using a Chi-squared test for estimates obtained from random-effects models.4465 articles were initially identified. After removing the duplicates and applying the selection criteria, we reviewed 62 full-text articles. Finally, 10 articles (n=2565 COPD patients) were included in this systematic review and meta-analyses. Overall, the prevalence of sarcopenia in patients with COPD was 21.6% (95% CI 14.6-30.9%, I2=94%), ranging from 8% in population-based to 21% in clinic-based studies, and 63% in COPD patients residing in nursing homes.Sarcopenia is frequently observed in COPD patients, with varying prevalence across population settings. Sarcopenia in COPD should be assessed using standardised tests and cut-off points from sarcopenia consensus criteria for clinical practice and international comparisons.

https://err.ersjournals.com/content/errev/28/154/190049.full.pdf

Sarcopenia in COPD: a systematic review and meta-analysis.

Sarcopenia prevalence and its clinical impact are reportedly variable in chronic obstructive pulmonary disease (COPD) due partly to definition criteria. This review aimed to identify the criteria used to diagnose sarcopenia and the prevalence and impact of sarcopenia on health outcomes in people with COPD. This review was registered in PROSPERO (CRD42018092576). Five electronic databases were searched to August 2018 to identify studies related to sarcopenia and COPD. Study quality was assessed using validated instruments matched to study designs. Sarcopenia prevalence was determined using authors' definitions. Comparisons were made between people who did and did not have sarcopenia for pulmonary function, exercise capacity, quality of life, muscle strength, gait speed, physical activity levels, inflammation/oxidative stress, and mortality. Twenty-three studies (70% cross-sectional) from Europe (10), Asia (9), and North and South America (4) involving 9637 participants aged ≥40 years were included (69.5% men). Sarcopenia criteria were typically concordant with recommendations of hEuropean and Asian consensus bodies. Overall sarcopenia prevalence varied from 15.5% [95% confidence interval (CI) 11.8-19.1; combined muscle mass, strength, and/or physical performance criteria] to 34% (95%CI 20.6-47.3; muscle mass criteria alone) (P = 0.009 between subgroups) and was greater in people with more severe [37.6% (95%CI 24.8-50.4)] versus less severe [19.1% (95%CI 10.2-28.0)] lung disease (P = 0.020), but similar between men [41.0% (95%CI 26.2-55.9%)] and women [31.9% (95%CI 7.0-56.8%)] (P = 0.538). People with sarcopenia had lower predicted forced expiratory volume in the first second (mean difference -7.1%; 95%CI -9.0 to -5.1%) and poorer exercise tolerance (standardized mean difference -0.8; 95%CI -1.4 to -0.2) and quality of life (standardized mean difference 0.26; 95%CI 0.2-0.4) compared with those who did not (P < 0.001 for all). No clear relationship was observed between sarcopenia and inflammatory or oxidative stress biomarkers. Incident mortality was unreported in the literature. Sarcopenia is prevalent in a significant proportion of people with COPD and negatively impacts upon important clinical outcomes. Opportunities exist to optimize its early detection and management and to evaluate its impact on mortality in this patient group.

/pdf/diagnosis-prevalence-and-clinical-impact-of-sarcopenia-in-44h1srxlw9.pdf

Diagnosis, prevalence, and clinical impact of sarcopenia in COPD: a systematic review and meta-analysis.

Population aging is a global issue, but is estimated to be more rapid and dramatic in Asian countries. In the past, allergy might have been a minor concern in the elderly (usually defined as ≥65 years). However, recent series of epidemiologic studies indicate that allergic diseases are more prevalent than expected in the aged population. Furthermore, they pose significant impact on quality of life and socioeconomic costs. The burden may also increase in the elderly, due to frequent comorbidities and treatment-related complications. The Korean Longitudinal Study on Health and Aging (KLoSHA) cohort study is one of major research projects on the epidemiology of common geriatric disease conditions in Korea. In this review, we summarized the baseline findings on the prevalence, risk factors, comorbidities and impact of geriatric respiratory allergic conditions in the phase I KLoSHA cohort study.

/pdf/respiratory-allergies-in-the-elderly-findings-from-the-2gtx6251na.pdf

Respiratory allergies in the elderly: findings from the Korean Longitudinal Study on Health and Aging phase I study (2005–2006)

Diagnosis, prevalence and clinical impact of sarcopenia in COPD: a systematic review and meta-analysis

There are few reports investigating the relationship between bronchial asthma (BA) and heart failure (HF). We hypothesized BA may have impact on prognosis in patients with HF. Among 323 consecutive outpatients with HF, 191 patients without chronic obstructive pulmonary disease were analyzed. Twenty patients had BA, most of whom (80.0%) had preserved left ventricular ejection fraction (LVEF ≥ 50%). The use of β-blockers was less frequent (55.0% vs 83.0%. p = 0.01), systolic blood pressure (133 ± 22 vs 120 ± 17 mmHg, p = 0.003), and heart rate (83 ± 14 vs 74 ± 15 bpm, p = 0.02) were higher in patients with BA than those without BA. During median follow up of 24 months, 45 (23.6%) experienced primary outcome defined as a composite of all-cause death, nonfatal myocardial infarction, nonfatal ischemic stroke, and unexpected hospitalization due to HF. Multivariate Cox regression analysis revealed that the presence of BA was independently associated with the occurrence of primary outcome (hazard ratio 3.08, 95% CI 1.42–6.71, p = 0.004). In the subgroup analysis of patients with preserved LVEF, patients with BA exhibited worse outcomes (p = 0.03 by log-rank). Patients with HF complicated by BA, most of whom had preserved LVEF, exhibited worse outcomes than those without BA.

Prognostic role of bronchial asthma in patients with heart failure

Sarcopenia en ancianos con antecedente de EPOC/asma : resultados del estudio SABE - Bogotá

/pdf/asociacion-entre-tamizacion-de-cancer-de-prostata-2a9ue4hl9m.pdf

Asociación entre tamización de cáncer de próstata, vinculación al sistema de salud y factores asociados en adultos mayores: análisis secundario de la encuesta SABE Bogotá, Colombia

Julián David Ríos-Zuluaga

Papers

Sarcopenia en ancianos con antecedente de EPOC/asma : resultados del estudio SABE - Bogotá

Asociación entre tamización de cáncer de próstata, vinculación al sistema de salud y factores asociados en adultos mayores: análisis secundario de la encuesta SABE Bogotá, Colombia