Analysis Of Risk Factors Associated With Sarcopenia And Bone Metabolism Abnormality In Patients With COPD

ObjectiveTo observe the changes of body composition,dominant grip strength and calcaneal bone density in patients with COPD and to identify the risk factors associated with sarcopenia in patients with COPD and their abnormal bone metabolism.Methods96 patients with COPD in the Department of Respiratory of the first affiliated Hospital of Jinzhou Medical University from September to December 2016 were selected as experimental group.52 healthy persons were selected as control group matched with the patients.The basic data(age,sex,smoking history)and the basic clinical data(course of disease,pulmonary function,acute exacerbation times in one year,whether asthma,history of glucocorticoid use and m MRC)were collected in two groups.The body composition,calcaneal bone mineral density,dominant hand grip strength of the two groups were measured.T-test,Pearson correlation analysis,Chi-square test and regression analysis were used to analyze the changes of body composition,risk factors and bone metabolism in patients with COPD.Results1.Comparison of body composition between COPD experimental group and healthy control group : there was no significant difference in height,fat content and fat body mass index between two groups(P>0.05).The muscle volume and SMI in COPD group were lower than those in healthy control group,and the FFMI in male group was lower than that in healthy control group,the difference was statistically significant(P<0.05).There was no significant difference in FFMI between the female COPD group and the healthy control group.(P>0.05).There was no statistical significance(P>0.05)for the correlation analysis between FEV1% and the skeletal muscle content.2.Comparison of grip strength and incidence of sarcopenia in COPD group and healthy control group: the grip strength of male COPD group was(34.25±8.95kg)lower than that of control group(36.43±8.46kg)(P<0.05),but the female COPD group’s was(21.15±5.75kg)higher than that of control group(20.51±4.99kg),the difference is not statistically significant.The incidence of sarcopenia in the COPD group(28.4%)was significantly higher than that in control group(5.58%)(χ2 =10.616,P=0.001).3.The risk factors of sarcopenia in patients with COPD:age,medical history,long-term smoking history and BMI were the risk factors associated with sarcopenia in patients with CODP(P<0.05).BMI was negatively correlated with the onset of sarcopenia.4.The incidence of osteoporosis of obstructive pulmonary disease was 18.8%,which was higher than the healthy control group(5.8%),the difference was statistically significant(X2=4.668,P<0.05).The T-score is negatively correlated with the time of using glucocorticoid(r:-0.319,P<0.05).Conclusions1.The body composition in patients with COPD changes,such as decrease of skeletal muscle content.They complicated with sarcopenia easily,which age,course of disease,long-term smoking history and BMI were the risk factors.2.Patients with COPD who have a long history of glucocorticoid use are prone to osteoporosis.