The Influence Factors Of AECOPD Complicated With Sarcopenia And The Value Of CC In Its Screening

Objective(s):To analyze the influence factors of sarcopenia in AECOPD patients,explore the correlation between CC,lung function indicators and sarcopenia indicators(PMI,grip strength,walking speed)in AECOPD patients,evaluate the screening value of CC in AECOPD with sarcopenia,early screening and intervention of sarcopenia in AECOPD patients.Methods:A total of 40 patients with AECOPD hospitalized from January 2022 to December 2022 were included in a cross-sectional survey.Muscle mass was assessed by computed tomography(CT)imaging and psoas mass index(PMI)was calculated at the third lumbar(L3)level.Then grip strength and 6 m daily walking speed were measured.Patients were divided into two groups: 17 patients in the sarcopenia group and 23 patients in the non-sarcopenia group.General data,BMI,inflammatory markers,nutritional markers [25-(OH)-D,ALB,HGB,TC],MNA score,lung function,length of stay and BODE index of all patients were collected and the differences between the two groups were compared.Single logistic regression analysis the influence factors of AECOPD combined with sarcopenia.To explore the correlation between CC,lung function indicators and sarcopenia indicators(PMI,grip strength,walking speed)in AECOPD patients,evaluate the screening value of CC for sarcopenia in AECOPD.Results:1.The prevalence of sarcopenia in AECOPD was 42.50%.Compared with the two groups,the body mass index(BMI)of sarcopenia group was lower(p < 0.05),but there were no differences in gender,age,smoking history,intravenous hormone using history,hypertension,diabetes and coronary heart disease history(p > 0.05).2.The MNA score of sarcopenia group was lower than non-sarcopenia group(p< 0.05).There were no significant differences in IL-6,PCT,hs-CRP,WBC,NEUT,LYMPH,NLR,FIB,25-(OH)-D,ALB,HGB,and TC between two groups(p > 0.05).Univariate logistic regression analysis suggested that BMI and MNA scores were protective factors for sarcopenia.3.The pulmonary function indexes FVC,FEV1,FEV1% and PEF in sarcopenia group were lower than those in non-sarcopenia group,while the number of hospital stay,BODE index and the proportion of poor prognosis in sarcopenia group were higher than those in non-sarcopenia group,with statistical significance(p < 0.05).4.In AECOPD patients,FVC,FEV1 and PEF were positively correlated with PMI,grip strength and walking speed respectively(p < 0.05);There was a positive correlation between FEV1% and walking speed(p < 0.05),but no correlation between FEV1% and PMI and grip strength(p > 0.05).5.CC in patients with AECOPD was positively correlated with PMI,grip strength and walking speed(p < 0.01).The area under ROC curve AUC of CC in screening AECOPD with sarcopenia was 0.884,95%CI: 0.784—0.983.The sensitivity and specificity were 73.9% and 88.2%.and the optimal cut-off value was 31.35 cm.Conclusion(s):1.Patients with AECOPD may be more susceptible to sarcopenia.2.High BMI and MNA scores are protective factors for patients with sarcopenia in AECOPD.3.Patients with AECOPD combined with sarcopenia have worse lung function and a higher risk of poor prognosis.4.Decreased PMI,grip strength,and walking speed of AECOPD patients are related to lung function impairment.5.CC measurement has the certain value in the screening of AECOPD complicated with sarcopenia.