International Journal of COPD (Jun 2025)

The Interface of a Leaky Gut with Reduced Sarcopenia-Related Quality of Life (SarQoL) in Patients with Chronic Obstructive Pulmonary Disease

  • Qaisar R,
  • Karim A,
  • Muhammad T,
  • Ahmad F,
  • Marinho DA,
  • Arkadianos I,
  • Alkahtani S

Journal volume & issue
Vol. Volume 20, no. Issue 1
pp. 2049 – 2059

Abstract

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Rizwan Qaisar,1– 3 Asima Karim,1,4 Tahir Muhammad,5 Firdos Ahmad,1– 3 Daniel Almeida Marinho,6,7 Ioannis Arkadianos,8 Shaea Alkahtani9 1Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, 27272, United Arab Emirates; 2Space Medicine Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates; 3Cardiovascular Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates; 4Iron Biology Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates; 5Department of Biochemistry, Gomal Medical College, Dera Ismail Khan, 29111, Pakistan; 6Department of Sport Sciences, University of Beira Interior, Covilhã, 6200-001, Portugal; 7Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, Covilhã, 6200-001, Portugal; 8Head Quarter Office, European Lifestyle Medicine Organization (ELMO), Geneva, 1201, Switzerland; 9Exercise Physiology Department, College of Sport Sciences and Physical Activity, King Saud University, Riyadh, 11451, Saudi ArabiaCorrespondence: Shaea Alkahtani, Exercise Physiology Department, College of Sport Sciences and Physical Activity, King Saud University, Riyadh, 11451, Saudi Arabia, Tel +96611806304, Fax +966118063370, Email [email protected]: Patients with chronic obstructive pulmonary disease (COPD) frequently exhibit intestinal leaks and age-related muscle impairment, termed sarcopenia. The sarcopenia-related quality-of-life (SarQoL) is a tool to evaluate the quality of life of sarcopenic patients. However, the association of intestinal leak with SarQoL in COPD patients remains unknown.Methods: We recruited male controls (n=87, age=72.7± 6.7 years) and COPD patients (n=81, age=70.9± 5.8 years) to validate the Pashto version of SarQoL. This was followed by an investigation of the sarcopenia indices, including handgrip strength (HGS), skeletal mass index (SMI), and gait speed. We also measured plasma zonulin (a marker of intestinal leak) and lipopolysaccharides binding protein (LBP) (a marker of bacterial load).Results: We first confirmed the reliability of Pashto SarQoL by demonstrating its internal consistency, test-retest reliability, and absence of a floor-and-ceiling effect. Next, we report that COPD patients had higher plasma zonulin and LBP levels and lower SarQoL, HGS, SMI, and gait speed than controls (all p< 0.05). Plasma zonulin demonstrated inverse correlations with SarQoL domains for locomotion, functionality, activities of daily living, and cumulative SarQoL scores in COPD patients (all p< 0.05). Further, higher LBP levels were correlated with lower scores on SarQoL domains for physical and mental health, locomotion, functionality, fear, and cumulative SarQoL scores (all p< 0.05).Conclusion: In conclusion, intestinal leaks and associated bacterial load potentially contribute to reduced SarQoL in COPD patients. Future studies should investigate intestinal mucosal repair as a therapeutic option in COPD patients.Keywords: zonulin, SarQoL, quality of life, handgrip strength, COPD

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