Frequency and impact on clinical outcomes of sarcopenia in patients with idiopathic pulmonary fibrosis

Abstract

Objectives: Sarcopenia is a syndrome characterized by reduced muscle mass and function. It is well-recognized as a complication in chronic diseases such as chronic obstructive pulmonary disease. However, little is known about sarcopenia in patients with idiopathic pulmonary fibrosis (IPF). This study aimed to investigate the clinical characteristics of sarcopenia and the association between quality of life and sarcopenia in patients with IPF.

Methods: In this pilot cross-sectional study, 56 Japanese outpatients with IPF (49 men) were enrolled prospectively. Sarcopenia was diagnosed according to the criteria of the Asian Working Group for Sarcopenia 2019. Its associations with clinical parameters including age, pulmonary functions, physical performance, and patient-reported outcomes (PROs) were examined.

Results: The frequency of sarcopenia was 39.3% (n = 22) in this cohort. There were significant differences in St George's Respiratory Questionnaire (p = .005), modified Medical Research Council score (p = .004), and Hospital and Anxiety Depression Scale depression score (p = .030) between the sarcopenic and non-sarcopenic groups. On multivariate regression analysis, 6-min walk distance (6MWD) was an independent factor associated with sarcopenia (odds ratio 1.241, 95% confidence interval 1.016-1.515, p = .034).

Conclusion: Sarcopenia was associated with PROs and physical performance in patients with IPF.

Keywords: 6-min walk test; appendicular skeletal muscle index; bioimpedance analysis; depression; idiopathic pulmonary fibrosis; patient-reported outcome; quality of life; sarcopenia.

Figure 1.

Comparisons of the SGRQ score, modified MRC score, and HADS score between those with and without sarcopenia. Comparisons of the SGRQ score (a), modified MRC score (b), and HADS score (c) between IPF patients with and without sarcopenia are shown. * p < .05. Abbreviations: SGRQ, St. George’s Respiratory Questionnaire; MRC, Medical Research Councils; IPF, idiopathic pulmonary fibrosis; SGRQ-S, St. George’s Respiratory Questionnaire-Symptom score; SGRQ-A, St. George’s Respiratory Questionnaire-Activity score; SGRQ-I, St. George’s Respiratory Questionnaire-Impact score; SGRQ-T, St. George’s Respiratory Questionnaire-Total score; HADS-A, Hospital Anxiety and Depression Scale-Anxiety; HADS-D, Hospital Anxiety and Depression Scale-Depression.

Figure 2.

Receiver operating characteristic curves for predicting sarcopenia in patients with IPF. ROC curve of 6MWD for predicting sarcopenia. AUC is 0.873, and the optimal cut-off value is 370 m. Abbreviations: IPF, idiopathic pulmonary fibrosis; ROC, receiver operating characteristic; AUC, area under the curve; 6MWD, 6-min walk distance.