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. 2025 Jun 24:20:2049-2059.
doi: 10.2147/COPD.S511562. eCollection 2025.

The Interface of a Leaky Gut with Reduced Sarcopenia-Related Quality of Life (SarQoL) in Patients with Chronic Obstructive Pulmonary Disease

Rizwan Qaisar  1   2   3 , Asima Karim  1   4 , Tahir Muhammad  5 , Firdos Ahmad  1   2   3 , Daniel Almeida Marinho  6   7 , Ioannis Arkadianos  8 , Shaea Alkahtani  9
Affiliations

The Interface of a Leaky Gut with Reduced Sarcopenia-Related Quality of Life (SarQoL) in Patients with Chronic Obstructive Pulmonary Disease

Rizwan Qaisar et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Purpose: Patients with chronic obstructive pulmonary disease (COPD) frequently exhibit intestinal leaks and age-related muscle impairment, termed sarcopenia. The sarcopenia-related quality-of-life (SarQoL) is a tool to evaluate the quality of life of sarcopenic patients. However, the association of intestinal leak with SarQoL in COPD patients remains unknown.

Methods: We recruited male controls (n=87, age=72.7±6.7 years) and COPD patients (n=81, age=70.9±5.8 years) to validate the Pashto version of SarQoL. This was followed by an investigation of the sarcopenia indices, including handgrip strength (HGS), skeletal mass index (SMI), and gait speed. We also measured plasma zonulin (a marker of intestinal leak) and lipopolysaccharides binding protein (LBP) (a marker of bacterial load).

Results: We first confirmed the reliability of Pashto SarQoL by demonstrating its internal consistency, test-retest reliability, and absence of a floor-and-ceiling effect. Next, we report that COPD patients had higher plasma zonulin and LBP levels and lower SarQoL, HGS, SMI, and gait speed than controls (all p<0.05). Plasma zonulin demonstrated inverse correlations with SarQoL domains for locomotion, functionality, activities of daily living, and cumulative SarQoL scores in COPD patients (all p<0.05). Further, higher LBP levels were correlated with lower scores on SarQoL domains for physical and mental health, locomotion, functionality, fear, and cumulative SarQoL scores (all p<0.05).

Conclusion: In conclusion, intestinal leaks and associated bacterial load potentially contribute to reduced SarQoL in COPD patients. Future studies should investigate intestinal mucosal repair as a therapeutic option in COPD patients.

Keywords: COPD; SarQoL; handgrip strength; quality of life; zonulin.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Correlations of plasma zonulin levels with SarQoL domains of physical and mental health (A), locomotion (B), body composition (C), functionality (D), activities of daily living (E), leisure activities (F), fear (G), and percent cumulative scores (H) in controls and COPD patients.
Figure 2
Figure 2
Correlations of percent cumulative SarQoL scores with sarcopenia indices of HGS (A), SMI (B), and gait speed (C) in controls and COPD patients.
See this image and copyright information in PMC

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