Presence of sarcopenia in asthma–COPD overlap syndrome may be a risk factor for decreased bone-mineral density, unlike asthma: Korean National Health and Nutrition Examination Survey (KNHANES) IV and V (2008–2011)
Received 31 March 2017
Accepted for publication 24 June 2017
Published 7 August 2017 Volume 2017:12 Pages 2355—2362
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Richard Russell
Dong-Won Lee,1 Hyun-Jung Jin,2 Kyeong-Cheol Shin,2 Jin-Hong Chung,2 Hyoung-Woo Lee,3 Kwan-Ho Lee2
1Division of Pulmonology, Department of Internal Medicine, Andong Sungso Hospital, Andong, 2Division of Pulmonology and Allergy, 3Division of Endocrinology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, South Korea
Background: Sarcopenia and decreased bone-mineral density (BMD) are common in elderly people, and are major comorbidities of obstructive airway disease (OAD). However, the relationship between sarcopenia and BMD in each OAD phenotype, especially asthma–COPD overlap syndrome (ACOS), is not yet clear. We aimed to evaluate differences in BMD according to the presence of sarcopenia in each OAD phenotype.
Materials and methods: Among the research subjects in KNHANES IV and V (2008–2011), 5,562 were ≥50 years old and underwent qualified spirometry and dual-energy X-ray absorptiometry. A total of 947 subjects were included in the study: 89 had asthma, 748 COPD, and 110 ACOS.
Results: In the COPD and ACOS phenotypes, T-scores were lower in the sarcopenia group than the nonsarcopenia group. Prevalence rates of osteopenia and osteoporosis were higher in the sarcopenia group than the nonsarcopenia group. (P<0.001 and P=0.017, respectively). The sarcopenia group had higher risks of developing osteopenia, osteoporosis, and low BMD than the nonsarcopenia group in the ACOS phenotype (OR 6.620, 95% CI 1.129–38.828 [P=0.036], OR 9.611, 95% CI 1.133–81.544 [P=0.038], and OR 6.935, 95% CI 1.194–40.272 [P=0.031], respectively). However, in the asthma phenotype, the sarcopenia group showed no increased risk compared with the nonsarcopenia group.
Conclusion: In the ACOS phenotype, individuals with sarcopenia had a higher prevalence rate and higher risks of osteopenia and osteoporosis than those without sarcopenia among all OAD phenotypes.
Keywords: asthma, chronic obstructive pulmonary disease, asthma–COPD overlap syndrome, sarcopenia, bone-mineral density
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