Does the Body Composition Worsens From GOLD Categories A to D in Patients With COPD

SESSION TITLE: Airways 5 SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM PURPOSE: Body composition is an important prognostic factor in patients with chronic obstructive pulmonary disease (COPD) as weight loss and muscular wasting are responsible for low exercise capacity in these patients. Body composition is therefore important in the assessment of COPD patients. GOLD 2011 document has proposed a new combined assessment for COPD, categorising the patients from A to D. In this prospective study we aimed to investigate whether body composition worsens from categories A to D. METHODS: In this prospective study; patients were classified into four categories using the new GOLD classification. Symptoms were measured by COPD Assessment Test (CAT) and the modified Medical Research Council (mMRC) scale. Shuttle walk test and SGRQ were performed. Bioelectrical impedance method was used for the measurement of body mass (BMI) and fat free mass indexes (FFMI). RESULTS: 107 patients (90 male, age 65.7±8.03 yrs, FEV1% 58.05±19.35) with COPD were classified into group A (27.1%), group B (32.7%), group C (8.4%) group D (31.8%). The most common co-morbidity was cardiovascular diseases (63.5%) and most of them were assinged to group B (15.88%). Mean body mass index (BMI) was 26.08±5.35 kg/m2 and fat free mass index (FFMI) was 19.36±2.61 kg/m2 for all patients. Although there was no difference between the groups in terms of BMI, FFMI was significantly lower in group B [18.89 (14.91-22.43) kg/m2] than group C [21.80(11.79-22.95)kg/m2] and group A [20.24 (14.6-25.20) kg/m2] (p=0.06, p=0.006, respectively). Fat free mass index in group B was similar to group D [(18.70 (12.90-25.39) kg/m2] (p = 0.94). Besides; dyspnea, walking distance, quality of life parameters were worse in group B and D than group A and C. CONCLUSIONS: The patients in Group B are more symptomatic, have less walking distance, low FFMI, more cardiovascular comorbidities than the groups A and C, similar to group D patients. Although BMI is not significantly different among all groups, FFMI was lower in group B patients which is similar to group D. FFMI is a strong predictor of peripheral skeletal muscle weakness, exercise capacity, reduced health status, and mortality. Therefore measuring FFMI is important, particularly for group B and D patients according to the new combined assessment of COPD. CLINICAL IMPLICATIONS: Clinicians should be aware of that the patients in group B are more dyspneic, have shorter walking distance, low FFMI and more cardiovascular comorbidities than the groups A and C, very similar to the patients in group D. Also measuring FFMI is a better tool for evaluating body composition. DISCLOSURE: The following authors have nothing to disclose: Alev Gurgun, Funda Elmas Uysal, Pervin Korkmaz Ekren, Volkan Karadag No Product/Research Disclosure Information