Open AccessSystemic Changes in Patients with Chronic Obstructive Pulmonary Disease (COPD): Two Years of Follow-up
Author(s) -
Roxana Gabriela Galesanu,
Sarah Bernard,
Jean Bourbeau,
Annie Michaud,
François Maltais
Publication year - 2007
Publication title -
clinical and investigative medicine
Language(s) - English
Resource type - Journals
eISSN - 1488-2353
pISSN - 0147-958X
DOI - 10.25011/cim.v30i3.1740
Subject(s) - medicine , lean body mass , copd , exacerbation , wasting , cohort , systemic inflammation , quality of life (healthcare) , prospective cohort study , cohort study , pulmonary function testing , inflammation , body weight , nursing
Background: There is a lack of information concerning the natural evolution of the systemic manifestations related to COPD. The aim of this study was to observe the evolution of the systemic manifestations (muscle wasting, inflammation) related to COPD over a two-year period and to assess their relationships with clinical outcomes (exacerbations and worsening in quality of life) in a longitudinal prospective cohort.
Methods: Forty-eight patients with COPD (FEV1: 42 ± 14 % predicted, lean mass: 49 ± 10 kg, 6-min walking distance: 422 ± 112 m, total SGRQ score: 45 ± 17) were included. Baseline and annual follow-up for body composition by DEXA scan, blood cytokines (CRP, IL-6), arterial blood gases, pulmonary function tests and quality of life were obtained. The number of acute exacerbations was recorded.
Results: Overall, FEV1, lean body mass, 6-min walking distance and blood inflammatory markers did not change over the two years. During this time, the SGRQ scores decreased by 4 ± 11 points (P=0.021) and 2.7 ± 2.4 exacerbations per patient were observed. There was no relationship between the changes in physiological measures and the fall in SGRQ or the exacerbation rate. A loss in lean body mass > 3% was observed in 11 (23%) patients but this was not associated with any adverse clinical outcomes nor with further loss in FEV1, walking distance and inflammatory status.
Conclusion: This cohort of patients remained remarkably stable over a 2-year follow-up period. A small loss in lean body mass was observed in some patients but this could not be associated with adverse clinical outcomes during this period.