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. 2022 Aug 1:15:4367-4384.
doi: 10.2147/JIR.S366204. eCollection 2022.

Skeletal Myosteatosis is Associated with Systemic Inflammation and a Loss of Muscle Bioenergetics in Stable COPD

Hans Lennart Persson #  1   2 , Apostolos Sioutas #  1   2 , Magnus Kentson  1   3 , Petra Jacobson  1   2 , Peter Lundberg  1   4   5 , Olof Dahlqvist Leinhard  1   5   6 , Mikael Fredrik Forsgren  1   5   6
Affiliations

Skeletal Myosteatosis is Associated with Systemic Inflammation and a Loss of Muscle Bioenergetics in Stable COPD

Hans Lennart Persson et al. J Inflamm Res. .

Abstract

Background: Common features among patients with more advanced chronic obstructive pulmonary disease (COPD) are systemic inflammation and a loss of both muscle mass and normal muscle composition. In the present study, we investigated COPD subjects to better understand how thigh muscle fat infiltration (MFI) and energy metabolism relate to each other and to clinical features of COPD with emphasis on systemic inflammation.

Methods: Thirty-two Caucasians with stable COPD were investigated using questionnaires, lung function tests, blood analysis and magnetic resonance imaging (MRI) for analysis of body- and thigh muscle composition. Bioenergetics in the resting thigh muscle, expressed as the PCr/Pi ratio, were analysed using 31phosphorus magnetic resonance spectroscopy (31P-MRS).

Results: Based on the combination of the MFI adjusted for sex (MFIa) and the thigh fat-tissue free muscle volume, expressed as the deviation from the expected muscle volume of a matched virtual control group (FFMVvcg), all COPD subjects displayed abnormally composed thigh muscles. Clinical features of increased COPD severity, including a decrease of blood oxygenation (r = -0.44, p < 0.05) and FEV1/FVC ratio, reflecting airway obstruction (r = -0.53, p < 0.01) and an increase of COPD symptoms (r = 0.37, p < 0.05) and breathing frequency at rest (r = 0.41, p < 0.05), were all associated with a raise of the PCr/Pi ratio in the thigh muscle. Increased MFIa of the thigh muscle correlated positively with markers of systemic inflammation (white blood cell count, r = 0.41, p < 0.05; fibrinogen, r = 0.44, p < 0.05), and negatively with weekly physical activity (r = -0.40, p < 0.05) and the PCr/Pi ratio in the resting thigh muscle (r = -0.41, p < 0.05).

Conclusion: The present study implies a link between systemic inflammation, excessive MFI and a loss of bioenergetics in subjects with stable COPD.

Keywords: 31P-MRS; adiposity; biomarkers; body composition; magnetic resonance imaging; muscle fat infiltration.

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Conflict of interest statement

HLP reports honoraria for advisory boards/lectures from AstraZeneca, Boehringer Ingelheim, GlaxoSmithCline, InterMune and Roche. ODL is a board-member, employee, and stockholder of AMRA Medical AB. ODL also has patents issued and pending to AMRA MEDICAL AB. MFF is an employee of AMRA Medical AB. PL is a stockholder of AMRA Medical AB.

Figures

Figure 1
Figure 1
A representative example of a 31P-MRS for a subject in the cohort.
Figure 2
Figure 2
The body composition plot is shown for the two groups.
Figure 3
Figure 3
Muscle composition assessment of the COPD subjects by GOLD stage.
Figure 4
Figure 4
Correlations of MFIa and (A) thigh muscle bioenergetics, expressed as the PCr/Pi ratio, and (B) VATi (L/m2).
See this image and copyright information in PMC

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