J Cachexia Sarcopenia Muscle. 2021;12(6):2145-2153.

Relationships between lung function decline and skeletal muscle and fat mass changes: a longitudinal study in healthy individuals.

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제1저자 박한기, 이소희 · 교신저자 박흥우

PMID 34612015 PMC8718064 DOI 10.1002/jcsm.12821 IF 9.9 알레르기내과

소속 (6)

Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
Department of Internal Medicine, Kyungpook National University Chilgok Hospital, Daegu, Korea.
Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea.
Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND The associations between long-term changes in body mass composition and decline in lung function in healthy adults are unknown.

METHODS Using a well-defined health check-up database, we first assessed individual longitudinal changes in muscle mass (MM) and fat mass (FM) measured via bioelectrical impedance analyses. Then we classified the enrolled individuals into five body composition groups according to their MM index (MMI) [MM (kg)/height (m)² ] or FM index (FMI) [FM (kg)/height (m)² ] change rate quartiles. Linear mixed models adjusted for age, smoking status, height, and body mass index were used to analyse the rate of forced expiratory volume in 1 s (FEV1) decline and body composition groups.

RESULTS A total of 15 476 middle-aged individuals (6088 women [mean age ± standard deviation: 50.74 ± 7.44] and 9388 men [mean age ± standard deviation: 49.36 ± 6.99]) were enrolled. The mean number of measurements was 6.96 (interquartile range [IQR]: 5-9) over an average follow-up period of 8.95 years (IQR: 6.73-11.10). Decrease in MMI was significantly associated with accelerated FEV1 decline in men only (P = 1.7 × 10^-9 ), while increase in FMI was significantly associated with accelerated FEV1 decline in both women and men (P = 7.9 × 10^-10 and P < 2.0 × 10^-16 respectively). Linear mixed model analyses indicated that annual increase of 0.1 kg/m² in MMI was related to accelerated FEV1 decline by 30.79 mL/year (95% confidence interval [CI]: 26.10 to 35.48 mL/year) in men. Annual increase of 0.1 kg/m² in FMI was related to accelerated FEV1 decline by 59.65 mL/year in men (95% CI: 56.84 to 62.28 mL/year) and by 22.84 mL/year in women (95% CI: 18.95 to 26.74 mL/year). In body composition analysis, we found increase in MMI was significantly associated with attenuated FEV1 decline in men only (P = 1.7 × 10^-9 ), while increase in FMI was significantly associated with accelerated FEV1 decline in both women and men (P = 7.9 × 10^-10 and P < 2.0 × 10^-16 respectively). Individuals characterized with gain MM combined with loss of FM were associated with the most favourable outcome (i.e. the smallest rate of decline in FEV1) in both women and men. In men, loss of FM over time is more closely related with attenuated FEV1 decline than change in MM (gain or loss).

CONCLUSIONS Change in body composition over time can be used to identify healthy middle-aged individuals at high risk for rapid FEV1 decline.

Keywords

Body compositionFEV1Health screeningLung functionObesitySarcopenia

Figures

**Figure 1** Correlations between a rate of decline in FEV1 and a rate of change in muscle or fat mass index. *(A)* Rate of decline in FEV1 vs. rate of change in MMI in women. *(B)* Rate of decline in FEV1 vs. rate of change in FMI in women. *(C)* Rate of decline in FEV1 vs. rate of change in MMI in men. *(D)* Rate of decline in FEV1 vs. rate of change in FMI in men. Correlation is measured by the Pearson's methods. FEV1, forced expiratory volume in one second, FMI; fat mass index (kg/m²); MMI; muscle mass index (kg/m²).

**Figure 2** Changes in muscle and fat mass index over time according to quartiles. *(A)* MMI change in woman. *(B)* FMI change in woman. *(C)* MMI change in man. *(D)* FMI change in man. FMI, fat mass index (kg/m²); MMI, muscle mass index (kg/m²); Q, quartile.

**Figure 3** Rates of decline in FEV1 and FEV1p of five body composition groups in women and men. Data are presented as mean with 95% confidence interval. FEV1, forced expiratory volume in one second; FEV1p, FEV1 predicted value; MM, muscle mass; FM, fat mass; G, group.

그림 출처: PubMed Central 공개 논문 (PMC8718064)

Conflict of interest statement

All authors declare that none have conflict of interest related with this article.

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