Journal article
Longitudinal Association Between Muscle Loss and Mortality in Ever Smokers
Chest, Vol.161(4), pp.960-970
04/2022
DOI: 10.1016/j.chest.2021.10.047
PMCID: PMC9005860
PMID: 34785234
Abstract
Body composition measures, specifically low weight or reduced muscle mass, are associated with mortality in COPD, but the effect of longitudinal body composition changes is undefined.
Is the longitudinal loss of fat-free mass (FFM) associated with increased mortality, including in those with initially normal or elevated body composition metrics?
Participants with complete data for at least one visit in the COPDGene study (n = 9,268) and the ECLIPSE study (n = 1,760) were included and monitored for 12 and 8 years, respectively. Pectoralis muscle area (PMA) was derived from thoracic CT scans and used as a proxy for FFM. A longitudinal mixed submodel for PMA and a Cox proportional hazards submodel for survival were fitted on a joint distribution, using a shared random intercept parameter and Markov chain Monte Carlo parameter estimation.
Both cohorts demonstrated a left-shifted distribution of baseline FFM, not reflected in BMI, and an increase in all-cause mortality risk associated with longitudinal loss of PMA. For each 1-cm
PMA loss, mortality increased 3.1% (95% CI, 2.4%-3.7%; P < .001) in COPDGene, and 2.4% (95% CI, 0.9%-4.0%; P < .001) in ECLIPSE. Increased mortality risk was independent of enrollment values for BMI and disease severity [BODE (body mass, airflow obstruction, dyspnea, and exercise capacity) index quartiles] and was significant even in participants with initially greater than average PMA.
Longitudinal loss of PMA is associated with increased all-cause mortality, regardless of BMI or initial muscle mass. Consideration of novel screening tests and further research into mechanisms contributing to muscle decline may improve risk stratification and identify novel therapeutic targets in ever smokers.
Details
- Title: Subtitle
- Longitudinal Association Between Muscle Loss and Mortality in Ever Smokers
- Creators
- Stefanie E Mason - Brigham and Women's HospitalRafael Moreta-Martinez - Brigham and Women's HospitalWassim W Labaki - University of MichiganMatthew J Strand - National Jewish HealthElizabeth A Regan - National Jewish HealthJessica Bon - Department of Medicine, Division of Pulmonary, Allergy and Critical Care, Pittsburgh PARuben San Jose Estepar - Brigham and Women's HospitalRichard Casaburi - The Lundquist InstituteMerry-Lynn McDonald - University of Alabama at BirminghamHarry B Rossiter - The Lundquist InstituteBarry Make - National Jewish HealthMark T Dransfield - University of Alabama at BirminghamMeiLan K Han - University of MichiganKendra Young - Colorado School of Public HealthJeffrey L Curtis - University of MichiganKathleen Stringer - University of MichiganGreg Kinney - Colorado School of Public HealthJohn E Hokanson - Colorado School of Public HealthRaul San Jose Estepar - Brigham and Women's HospitalGeorge R Washko - Brigham and Women's HospitalCOPDGene Investigators
- Contributors
- Sean B Fain (Contributor) - University of Iowa, Radiology
- Resource Type
- Journal article
- Publication Details
- Chest, Vol.161(4), pp.960-970
- DOI
- 10.1016/j.chest.2021.10.047
- PMID
- 34785234
- PMCID
- PMC9005860
- NLM abbreviation
- Chest
- ISSN
- 0012-3692
- eISSN
- 1931-3543
- Grant note
- T32 HL007633 / NHLBI NIH HHS U01 HL089856 / NHLBI NIH HHS U01 HL089897 / NHLBI NIH HHS R01 HL089856 / NHLBI NIH HHS R01 HL151452 / NHLBI NIH HHS R01 HL089897 / NHLBI NIH HHS P50 HD098593 / NICHD NIH HHS
- Language
- English
- Date published
- 04/2022
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Electrical and Computer Engineering; Psychiatry
- Record Identifier
- 9984274955502771
Metrics
5 Record Views