J Bone Metab.  2019 May;26(2):65-74. 10.11005/jbm.2019.26.2.65.

Sarcopenia Associated with Chronic Obstructive Pulmonary Disease

Affiliations
  • 1Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea. drshinmj@gmail.com
  • 2Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.

Abstract

Sarcopenia is frequently associated with chronic diseases such as chronic obstructive pulmonary disease (COPD) and cancer. COPD, which is characterized by an irreversible airflow limitation, exacerbates respiratory distress as the disease progresses. The prevalence of sarcopenia in stable COPD was reported to be 15% to 25% in previous foreign studies and 25% in a Korean study. As the amount of activity decreases, muscle mass decreases and eventually oxygen cannot be used effectively, resulting in a vicious cycle of deterioration of exercise capacity. Deconditioning due to decreased activity is a major cause of limb muscle dysfunction in patients with COPD. In these patients, the factors that decrease muscle strength and endurance include chronic inflammation, oxidative stress, inactivity, hypoxemia, hormone abnormality, deficits of nutrients such as protein and vitamin D, and the use of systemic corticosteroid. Therefore, treatment and management should either inhibit this process or should be directed toward supplementing the deficiency, such as with exercise, nutritional support, and medications and supplements. The relationship between sarcopenia and COPD is increasingly being reported, with some overlap in clinical features and treatments. We are fascinated to be able to diagnose 2 diseases through similar physical performance tests and to improve both diseases using the same treatment such as exercise. Therefore, this review summarizes the clinical relevance and integrative management of the 2 diseases.

Keyword

Chronic obstructive; Exercise therapy; Pulmonary disease; Rehabilitation; Sarcopenia; Vitamin D

MeSH Terms

Anoxia
Chronic Disease
Exercise Therapy
Extremities
Humans
Inflammation
Lung Diseases
Muscle Strength
Nutritional Support
Oxidative Stress
Oxygen
Prevalence
Pulmonary Disease, Chronic Obstructive*
Rehabilitation
Sarcopenia*
Vitamin D
Oxygen
Vitamin D

Figure

  • Fig. 1 Vicious cycle of inactivity in chronic obstructive pulmonary disease.

  • Fig. 2 Exercise program for chronic obstructive pulmonary disease and sarcopenia.


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