An incidence of sarcopenia in patients with stable chronic obstructive pulmonary disease: a comparison of diagnostic algorithms of European Working Group on Sarcopenia in Older People, 2018 versus 2010

The first aim of this study was to compare an incidence  of sarcopenia in patients with chronic obstructive pulmonary disease (COPD) when using updated (2018) the European  Working Group on Sarcopenia in Older People (EWGSOP)  algorithm compared to the previous version (2010). The second aim was to determine relationships between clinical and functional parameters of COPD  and parameters of sarcopenia. Methods. The study involved 86 stable COPD  patients (68 males; mean age, 66.6 ± 8.7 years). The diagnosis of COPD  was made according to GINA 2019. Sarcopenia was diagnosed according to EWGSOP guidelines 2010 and 2018. Muscle mass was assessed using dual-energy Xray absorptiometry  (DXA). Results. Walking speed was measured in all patients according to EWGSOP guideline 2010. Additionally, hand muscle strength was measured in patients with walking speed > 0.8 m/s (n = 25). DXA was required to 72% of patients to confirm the diagnosis of sarcopenia. Sarcopenia was defined in 38 (44.1%) patients including severe sarcopenia in 20 (23.3%). According to results of SARC-F  questionnaire, further hand muscle strength measurement  was required to 64 patients and DXA was required to 51 (59.3%) patients. As a result, sarcopenia was confirmed in 38 (44.1%) patients including severe sarcopenia  in 34 (39.5%) patients.  The incidence  of sarcopenia  was higher in patients  with more  severe symptoms  of COPD  and more  severe bronchial obstruction  (р = 0.001), and in patients with emphysema (р < 0.03). Conclusion. The incidence of sarcopenia in COPD  patients did not differ when used different diagnostic algorithms (EWGSOP, 2010 vs 2018) and was 44.1%. The need in additional tests, including expensive tests, was lower and the incidence  of sarcopenia was higher (39.5% vs 23.3%) following the EWGSOP  algorithm,  2018, compared  to that of 2010. The incidence  of sarcopenia  increased  in more  severe COPD, in patients  with emphysema,  severe clinical symptoms,  severe and very severe bronchial obstruction.  The incidence of sarcopenia was not related to the patient’s age.

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