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Skeletal Muscle Adiposity and Lung Function Trajectory in the Severe Asthma Research Program (SARP)
Journal article   Open access   Peer reviewed

Skeletal Muscle Adiposity and Lung Function Trajectory in the Severe Asthma Research Program (SARP)

Matthew C Tattersall, Kristine E Lee, Nanae Tsuchiya, Fauzia Osman, Claudia E Korcarz, Kristin M Hansen, Michael C Peters, John V Fahy, Colin A Longhurst, Eleanor Dunican, …
American journal of respiratory and critical care medicine, Vol.207(4), pp.475-484
02/15/2023
DOI: 10.1164/rccm.202203-0597OC
PMCID: PMC9940151
PMID: 36194556
url
https://escholarship.org/content/qt6pp2g1x3/qt6pp2g1x3.pdfView
Open Access

Abstract

RATIONALEExtra-pulmonary manifestations of asthma, including fatty infiltration in tissues, may reflect systemic inflammation and influence lung function and disease severity. OBJECTIVESTo determine if skeletal muscle adiposity predicts lung function trajectory in asthma. METHODSAdult Severe Asthma Research Program-3 participants with baseline computed tomography imaging and longitudinal post-bronchodilator FEV1%-predicted (median follow-up 5 years [1132 person-years]) were evaluated. The mean (Hounsfield unit [HU]) of the left and right paraspinous muscle density (PSMD) at the 12th thoracic vertebral body was calculated. A lower PSMD reflects higher muscle adiposity. We derived PSMD reference ranges from healthy, non-asthma controls. A linear multivariable mixed-effects model evaluated associations of baseline PSMD, and lung function trajectory stratified by sex. MEASUREMENTS AND MAIN RESULTSParticipants included 219 with asthma (67% female, mean (SD) BMI of 32.3 [8.8] kg/m2); and 37 controls (51% female, mean [SD] BMI of 26.3 (4.7) kg/m2). Asthmatic participants had lower adjusted PSMD than controls (42.2 vs. 55.8 HU, p<0.001). In adjusted models, PSMD predicted lung function trajectory in asthmatic females, [(β= -0.47 Δ-slope per 10 HU decrease), p= 0.03], but not males [(β= 0.11 Δ-slope per 10 HU decrease), p= 0.77]. The highest PSMD tertile predicted a 2.9% improvement while the lowest tertile predicted a 1.8% decline in FEV1%-predicted among asthmatic females over 5 years. CONCLUSIONSAsthmatic participants have lower PSMD, reflecting greater muscle fat infiltration. Baseline PSMD predicted lung function decline among females with asthma, but not males. These data support an important role of metabolic dysfunction in lung function decline.

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