Pulmonary Rehabilitation Reduces the Sarcopenia Phenotype in Patients with Chronic Obstructive Pulmonary Disease

Abstract

Purpose: Sarcopenia or age-associated muscle decline is common in patients with chronic obstructive pulmonary disease (COPD). Pulmonary rehabilitation (PR) is an effective tool in reducing COPD phenotype, but its effects on sarcopenia and functional capacity are poorly known. We aimed to assess the restorative potential of PR on skeletal muscle and physical capacity in COPD patients. Methods: We investigated the male COPD patients, 56–71 years old (n = 55), through clinical examination, laboratory investigation, and spirometry. All patients were evaluated at two time points, 1 year apart before and following the PR. Reduced handgrip strength (HGS), appendicular skeletal mass index (ASMI), and gait speed were considered the clinical indexes of Sarcopenia. Enzyme-linked immunosorbent assay were used to measure the circulating markers of inflammation (C-reactive protein [CRP]) and oxidative stress (8-isoprostanes). Results: At baseline, the COPD patients had low HGS and gait speed and elevated CRP and 8-isoprostanes levels. According to four internationally recognized criteria, these patients also had a high incidence of Sarcopenia. One year of PR partially restored the HGS, gait speed, CRP, and 8-isoprostanes levels (all P < 0.05). However, the ASMI values were insignificantly restored following PR. PR also reduced the incidence of sarcopenia in COPD patients. Among various criteria for sarcopenia, the international working group on sarcopenia yielded the highest incidence of sarcopenia in COPD patients. Conclusion: Altogether, our data show the therapeutic potential of PR in skeletal muscle, physical performance, and systemic health in patients with COPD.

Keywords

• 8-isoprostanes
• chronic obstructive pulmonary disease
• c-reactive protein
• handgrip strength
• pulmonary rehabilitation
• sarcopenia