Login Register Cart 0
Generic placeholder image

Endocrine, Metabolic & Immune Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

Respiratory Function Correlates with Fat Mass Index and Blood Triglycerides in Institutionalized Older Individuals

Author(s): Francisco Miguel Martinez-Arnau, Cristina Buigues, Rosa Fonfría-Vivas and Omar Cauli*

Volume 22, Issue 10, 2022

Published on: 24 June, 2022

Page: [1029 - 1039] Pages: 11

DOI: 10.2174/1871530322666220329150813

Price: $65

Abstract

Background: We investigated the relationship between respiratory function measured by spirometry analysis and anthropometric variables (skeletal and fat mass) and nutritional status in the institutionalized elderly, particularly at high-risk for adverse outcomes after respiratory infections and malnutrition.

Design: This is a multicenter cross-sectional study with a quantitative approach conducted among older people institutionalized living in nursing homes.

Methods: Respiratory function was assessed by measuring the forced vital capacity, forced expiratory volume in the first second, the ratio between FEV1 and FVC (FEV1/FVC), and peak expiratory flow in percentage by means of spirometric analysis (values of the forced expiratory volume measured during the first second of the forced breath (FEV1) and forced vital capacity (FVC)). Nutritional assessment and anthropometry analyses were performed to evaluate under or over nutrition/weight.

Results: There was a significant (p<0.05) and positive correlation between FEV1 and skeletal muscle mass index, whereas fat mass index correlated significantly (p<0.01) with the FEV1/FVC index. FEV1/FVC values were both significantly (p<0.05) associated with high body mass index and triglyceride levels in the blood. The prevalence of individuals with ventilator restrictive pattern (FEV1/FVC>70% with FEV1 and FVC<80%) was 27.6% and 12 individuals (21.1%) received daily bronchodilators as part of the pharmacological treatment for respiratory disorders. Logistic regression was performed to identify predictors of restrictive respiratory patterns. The following variables were included in the model: age group, female gender, Charlson comorbidity index, body-mass index (BMI), fat mass index, skeletal muscle mass index, total cholesterol, and triglycerides concentration. The model was statistically significant (p < 0.05; R2 = 0.39), correctly classifying 70.0% of cases, with a sensitivity of 89.3% and a specificity of 50.0%. Area under curve was 0.71 (IC95% 0.54-0.88; p=0.023).The highest OR for the restrictive respiratory pattern was for BMI (OR=5.09) and triglycerides concentration in blood (>150 mg/dl) (OR=5.59).

Conclusion: The relationship between a restrictive pattern of respiratory function and fat mass deserves future investigation to manage these parameters as a possible modifiable factor of altered respiratory function in overweight institutionalized older individuals.

Keywords: Spirometry, triglycerides, respiratory system, skeletal muscles, lipids, fat mass, blood.

« Previous Next »
Graphical Abstract

[1]
Oliveira, P.D.; Wehrmeister, F.C.; Pérez-Padilla, R.; Gonçalves, H.; Assunção, M.C.F.; Horta, B.L.; Gigante, D.P.; Barros, F.C.; Menezes, A.M. Relationship between body composition and pulmonary function in early adult Life: A cross-sectional analysis nested in two birth cohort studies. PLoS One, 2016, 11(9), e0163428.
[http://dx.doi.org/10.1371/journal.pone.0163428] [PMID: 27682232]
[2]
Kawabata, R.; Soma, Y.; Kudo, Y.; Yokoyama, J.; Shimizu, H.; Akaike, A. Relationships between body composition and pulmonary function in a community-dwelling population in Japan. PLoS One, 2020, 15(11), e0242308.
[3]
Mohamed, E.I.; Maiolo, C.; Iacopino, L.; Pepe, M.; Di Daniele, N.; De Lorenzo, A. The impact of body-weight components on forced spirometry in healthy italians. Lung, 2002, 180(3), 149-159.
[http://dx.doi.org/10.1007/s004080000089] [PMID: 12177729]
[4]
McCormick, R.; Vasilaki, A. Age-related changes in skeletal muscle: Changes to life-style as a therapy. Biogerontology, 2018, 19(6), 519-536.
[http://dx.doi.org/10.1007/s10522-018-9775-3] [PMID: 30259289]
[5]
Marzuca-Nassr, G.N.; SanMartín-Calísto, Y.; Guerra-Vega, P.; Artigas-Arias, M.; Alegría, A.; Curi, R. Skeletal muscle aging atrophy: Assessment and exercise-based treatment. Adv. Exp. Med. Biol., 2020, 1260, 123-158.
[6]
Ohara, D.G.; Pegorari, M.S.; Oliveira Dos Santos, N.L.; de Fátima Ribeiro Silva, C.; Monteiro, R.L.; Matos, A.P.; Jamami, M. Respiratory muscle strength as a discriminator of sarcopenia in community-dwelling elderly: A cross-sectional study. J. Nutr. Health Aging, 2018, 22(8), 952-958.
[http://dx.doi.org/10.1007/s12603-018-1079-4] [PMID: 30272099]
[7]
Kera, T.; Kawai, H.; Hirano, H.; Kojima, M.; Watanabe, Y.; Motokawa, K.; Fujiwara, Y.; Ihara, K.; Kim, H.; Obuchi, S. Definition of respiratory sarcopenia with peak expiratory flow rate. J. Am. Med. Dir. Assoc., 2019, 20(8), 1021-1025.
[http://dx.doi.org/10.1016/j.jamda.2018.12.013] [PMID: 30737167]
[8]
Elliott, J.E.; Greising, S.M.; Mantilla, C.B.; Sieck, G.C. Functional impact of sarcopenia in respiratory muscles. Respir. Physiol. Neurobiol., 2016, 226, 137-146.
[http://dx.doi.org/10.1016/j.resp.2015.10.001] [PMID: 26467183]
[9]
Martínez-Arnau, F.M.; Buigues, C.; Fonfría-Vivas, R.; Cauli, O. Respiratory muscle strengths and their association with lean mass and handgrip strengths in older institutionalized individuals. J. Clin. Med., 2020, 9(9), 2727.
[http://dx.doi.org/10.3390/jcm9092727] [PMID: 32847002]
[10]
Wannamethee, S.G.; Shaper, A.G.; Whincup, P.H. Body fat distribution, body composition, and respiratory function in elderly men. Am. J. Clin. Nutr., 2005, 82(5), 996-1003.
[http://dx.doi.org/10.1093/ajcn/82.5.996] [PMID: 16280430]
[11]
Rossi, A.P.; Watson, N.L.; Newman, A.B.; Harris, T.B.; Kritchevsky, S.B.; Bauer, D.C. Effects of body composition and adipose tissue distribution on respiratory function in elderly men and women: The health, aging, and body composition study. J. Gerontol - Ser A Biol Sci Med Sci, 2011, 66 A(7), 801-8.
[12]
Czapla, Z.; John, A.; Szwed, A.; Hanć, T.; Durda, M.; Ratajczak, J.; Barłóg, E. Influence of body shape composition on respiratory function in adult women. Adv. Exp. Med. Biol., 2016, 910, 55-62.
[http://dx.doi.org/10.1007/5584_2015_208] [PMID: 26820735]
[13]
Schweitzer, L.; Geisler, C.; Johannsen, M.; Glüer, C.C.; Müller, M.J. Associations between body composition, physical capabilities and pulmonary function in healthy older adults. Eur. J. Clin. Nutr., 2017, 71(3), 389-394.
[http://dx.doi.org/10.1038/ejcn.2016.146] [PMID: 27507070]
[14]
Pan, J.; Xu, L.; Lam, T.H.; Jiang, C.Q.; Zhang, W.S.; Jin, Y.L.; Zhu, F.; Zhu, T.; Thomas, G.N.; Cheng, K.K.; Adab, P. Association of adiposity with pulmonary function in older Chinese: Guangzhou Biobank Cohort Study. Respir. Med., 2017, 132, 102-108.
[http://dx.doi.org/10.1016/j.rmed.2017.10.003] [PMID: 29229080]
[15]
Opina, M.T.D.; Brinkley, T.E.; Gordon, M.; Lyles, M.F.; Nicklas, B.J. Association of breathing reserve at peak exercise with body composition and physical function in older adults with obesity. Med. Sci., 2019, 74(12), 1973-1979.
[http://dx.doi.org/10.1093/gerona/gly276] [PMID: 30535050]
[16]
Soeters, P.B.; Reijven, P.L.M. van Bokhorst-de van der Schueren, M.A.; Schols, J.M.; Halfens, R.J.; Meijers, J.M.; van Gemert, W.G. A rational approach to nutritional assessment. Clin. Nutr., 2008, 27(5), 706-716.
[http://dx.doi.org/10.1016/j.clnu.2008.07.009] [PMID: 18783855]
[17]
Miller, M.R.; Hankinson, J.; Brusasco, V.; Burgos, F.; Casaburi, R.; Coates, A.; Crapo, R.; Enright, P.; van der Grinten, C.P.; Gustafsson, P.; Jensen, R.; Johnson, D.C.; MacIntyre, N.; McKay, R.; Navajas, D.; Pedersen, O.F.; Pellegrino, R.; Viegi, G.; Wanger, J. Standardisation of spirometry. Eur. Respir. J., 2005, 26(2), 319-338.
[http://dx.doi.org/10.1183/09031936.05.00034805] [PMID: 16055882]
[18]
Quanjer, P.H.; Brazzale, D.J.; Boros, P.W.; Pretto, J.J. Implications of adopting the Global Lungs Initiative 2012 all-age reference equations for spirometry. Eur. Respir. J., 2013, 42(4), 1046-1054.
[http://dx.doi.org/10.1183/09031936.00195512] [PMID: 23520323]
[19]
Nunn, A.J.; Gregg, I. New regression equations for predicting peak expiratory flow in adults. BMJ, 1989, 298(6680), 1068-1070.
[http://dx.doi.org/10.1136/bmj.298.6680.1068] [PMID: 2497892]
[20]
Marks, G.B. Are reference equations for spirometry an appropriate criterion for diagnosing disease and predicting prognosis? Thorax, 2012, 67(1), 85-87.
[http://dx.doi.org/10.1136/thoraxjnl-2011-200584] [PMID: 21825082]
[21]
Backman, H.; Eriksson, B.; Hedman, L.; Stridsman, C.; Jansson, S.A.; Sovijärvi, A.; Lindberg, A.; Rönmark, E.; Lundbäck, B. Restrictive spirometric pattern in the general adult population: Methods of defining the condition and consequences on prevalence. Respir. Med., 2016, 120, 116-123.
[http://dx.doi.org/10.1016/j.rmed.2016.10.005] [PMID: 27817808]
[22]
Mohamed Hoesein, F.A.A.; Zanen, P.; Lammers, J.W.J. Lower limit of normal or FEV1/FVC < 0.70 in diagnosing COPD: An evidence-based review. Respir. Med., 2011, 105(6), 907-915.
[http://dx.doi.org/10.1016/j.rmed.2011.01.008] [PMID: 21295958]
[23]
Camina-Martín, M.A.; de Mateo-Silleras, B.; Malafarina, V.; Lopez-Mongil, R.; Niño-Martín, V.; López-Trigo, J.A.; Redondo-Del-Río, M.P. Nutritional status assessment in geriatrics: consensus declaration by the spanish society of geriatrics and gerontology nutritionwork group. Rev. Esp. Geriatr. Gerontol., 2016, 51(1), 52-57.
[PMID: 26388249]
[24]
Janssen, I.; Heymsfield, S.B.; Baumgartner, R.N.; Ross, R. Estimation of skeletal muscle mass by bioelectrical impedance analysis. J. Appl. Physiol., 2000, 89(2), 465-471.
[http://dx.doi.org/10.1152/jappl.2000.89.2.465] [PMID: 10926627]
[25]
Vellas, B.; Villars, H.; Abellan, G.; Soto, M.E.; Rolland, Y.; Guigoz, Y. Overview of the MNA® - Its history and challenges. J. Nutr. Health Aging, 2006, 456-463.
[26]
Matsuo, H.; Yoshimura, Y.; Fujita, S.; Maeno, Y. Risk of malnutrition is associated with poor physical function in patients undergoing cardiac rehabilitation following heart failure. Nutr. Diet., 2019, 76(1), 82-88.
[http://dx.doi.org/10.1111/1747-0080.12465] [PMID: 30155947]
[27]
Jamaiyah, H., Jr; Geeta, A.; Safiza, M.N.; Wong, N.F.; Kee, C.C.; Ahmad, A.Z.; Suzana, S.; Rahmah, R.; Khor, G.L.; Ruzita, A.T.; Chen, W.S.; Rajaah, M.; Faudzi, A. Reliability and technical error of calf circumference and mid-half arm span measurements for nutritional status assessment of elderly persons in malaysia. Malays. J. Nutr., 2008, 14(2), 137-150.
[PMID: 22691771]
[28]
Schaap, L.A.; Quirke, T.; Wijnhoven, H.A.H.; Visser, M. Changes in body mass index and mid-upper arm circumference in relation to all-cause mortality in older adults. Clin. Nutr., 2018, 37(6 Pt A), 2252-2259.
[http://dx.doi.org/10.1016/j.clnu.2017.11.004] [PMID: 29195733]
[29]
Setiati, S.; Istanti, R.; Andayani, R.; Kuswardhani, R.A.T.; Aryana, I.G.P.S.; Putu, I.D.; Apandi, M.; Ichwani, J.; Soewoto, S.; Dinda, R.; Mustika, S. Cut-off of anthropometry measurement and nutritional status among elderly outpatient in Indonesia: Multi-centre study. Acta Med. Indones., 2010, 42(4), 224-230.
[PMID: 21063044]
[30]
Nordestgaard, B.G.; Varbo, A. Triglycerides and cardiovascular disease. Lancet, 2014, 384, 626-635.
[31]
Cruz-Jentoft, A.J.; Bahat, G.; Bauer, J.; Boirie, Y.; Bruyère, O.; Cederholm, T.; Cooper, C.; Landi, F.; Rolland, Y.; Sayer, A.A.; Schneider, S.M.; Sieber, C.C.; Topinkova, E.; Vandewoude, M.; Visser, M.; Zamboni, M.; Bautmans, I.; Baeyens, J-P.; Cesari, M.; Cherubini, A.; Kanis, J.; Maggio, M.; Martin, F.; Michel, J-P.; Pitkala, K.; Reginster, J-Y.; Rizzoli, R.; Sánchez-Rodríguez, D.; Schols, J. Sarcopenia: Revised European consensus on definition and diagnosis. Age Ageing, 2019, 48(1), 16-31.
[http://dx.doi.org/10.1093/ageing/afy169] [PMID: 30312372]
[32]
Sharma, G.; Goodwin, J. Effect of aging on respiratory system physiology and immunology. Clin. Interv. Aging, 2006, 1(3), 253-260.
[http://dx.doi.org/10.2147/ciia.2006.1.3.253] [PMID: 18046878]
[33]
Bonnefoy, M.; Jauffret, M.; Kostka, T.; Jusot, J.F. Usefulness of calf circumference measurement in assessing the nutritional state of hospitalized elderly people. Gerontology, 2002, 48(3), 162-169.
[http://dx.doi.org/10.1159/000052836] [PMID: 11961370]
[34]
Yoshikawa, M.; Yoneda, T.; Takenaka, H.; Fukuoka, A.; Okamoto, Y.; Narita, N.; Nezu, K. Distribution of muscle mass and maximal exercise performance in patients with COPD. Chest, 2001, 119(1), 93-98.
[http://dx.doi.org/10.1378/chest.119.1.93] [PMID: 11157589]
[35]
Chumlea, W.C. Is the MNA valid in different populations and across practice settings? J. Nutr. Health Aging, 2006, 10(6), 524-527.
[PMID: 17183424]
[36]
Villaça, D.S.; Lerario, M.C.; dal Corso, S.; Nápolis, L.; de Albuquerque, A.L.P.; Lazaretti-Castro, M.; Sachs, A.; Nery, L.E.; Neder, J.A. Clinical value of anthropometric estimates of leg lean volume in nutritionally depleted and non-depleted patients with chronic obstructive pulmonary disease. Br. J. Nutr., 2008, 100(2), 380-386.
[http://dx.doi.org/10.1017/S0007114507886399] [PMID: 18184453]
[37]
Ho, S.C.; Hsu, M.F.; Kuo, H.P.; Wang, J.Y.; Chen, L.F.; Lee, K.Y.; Chuang, H.C. The relationship between anthropometric indicators and walking distance in patients with chronic obstructive pulmonary disease. Int. J. Chron. Obstruct. Pulmon. Dis., 2015, 10(1), 1857-1862.
[http://dx.doi.org/10.2147/COPD.S87714] [PMID: 26392760]
[38]
Ho, S.C.; Wang, J.Y.; Kuo, H.P.; Huang, C.D.; Lee, K.Y.; Chuang, H.C.; Feng, P.H.; Chen, T.T.; Hsu, M.F. Mid-arm and calf circumferences are stronger mortality predictors than body mass index for patients with chronic obstructive pulmonary disease. Int. J. Chron. Obstruct. Pulmon. Dis., 2016, 11(1), 2075-2080.
[PMID: 27621613]
[39]
Jiang, X.L.; Zhong, P.; Huang, C.L.; He, F.; Fan, X.M.; Chen, X.R. The relationship between nutritional status and oxidative stress markers, pulmonary function in patients with stable chronic obstructive pulmonary disease. Zhonghua Jie He He Hu Xi Za Zhi, 2017, 40(1), 40-45.
[PMID: 28100361]
[40]
Charles, A.; Buckinx, F.; Cataldo, D.; Rygaert, X.; Gruslin, B.; Reginster, J.Y.; Bruyère, O. Relationship between peak expiratory flow and incidence of frailty, deaths and falls among nursing home residents: Results of the senior cohort. Arch. Gerontol. Geriatr., 2019, 85, 103913.
[http://dx.doi.org/10.1016/j.archger.2019.103913] [PMID: 31357107]
[41]
Deniz, O.; Coteli, S.; Karatoprak, N.B.; Pence, M.C.; Varan, H.D.; Kizilarslanoglu, M.C. Diaphragmatic muscle thickness in older people with and without sarcopenia. Aging Clin. Exp. Res., 2020.
[PMID: 32406014]
[42]
Nagano, A.; Wakabayashi, H.; Maeda, K.; Kokura, Y.; Miyazaki, S.; Mori, T. Respiratory sarcopenia and sarcopenic respiratory disability: Concepts, diagnosis, and treatment. J. Nutr. Health Aging, 2021, 25(4), 507-515.
[43]
Rossi, A.; Fantin, F.; Di Francesco, V.; Guariento, S.; Giuliano, K.; Fontana, G.; Micciolo, R.; Solerte, S.B.; Bosello, O.; Zamboni, M. Body composition and pulmonary function in the elderly: A 7-year longitudinal study. Int. J. Obes., 2008, 32(9), 1423-1430.
[http://dx.doi.org/10.1038/ijo.2008.103] [PMID: 18645577]
[44]
Melo, L.C.; Silva, M.A.; Calles, A.C. Obesity and lung function: A systematic review. Einstein (Sao Paulo), 2014, 12(1), 120-125.
[http://dx.doi.org/10.1590/S1679-45082014RW2691] [PMID: 24728258]
[45]
Rabec, C.; de Lucas Ramos, P.; Veale, D. Respiratory complications of obesity. Arch. Bronconeumol., 2011, 47(5), 252-261.
[PMID: 21458904]
[46]
Jones, R.L.; Nzekwu, M.M.U. The effects of body mass index on lung volumes. Chest, 2006, 130(3), 827-833.
[http://dx.doi.org/10.1378/chest.130.3.827] [PMID: 16963682]
[47]
Rafie, S.; Moitra, S.; Brashier, B.B. Association between the serum metabolic profile and lung function in chronic obstructive pulmonary disease. Turk. Thorac. J., 2018, 19(1), 13-18.
[http://dx.doi.org/10.5152/TurkThoracJ.2017.17043] [PMID: 29404181]
[48]
Chen, W.L.; Wang, C.C.; Wu, L.W.; Kao, T.W.; Chan, J.Y.H.; Chen, Y.J.; Yang, Y.H.; Chang, Y.W.; Peng, T.C. Relationship between lung function and metabolic syndrome. PLoS One, 2014, 9(10), e108989.
[http://dx.doi.org/10.1371/journal.pone.0108989] [PMID: 25299452]
[49]
Tanni, S.E.; Zamuner, A.T.S.; Coelho, L.S.; Vale, S.A.; Godoy, I.; Paiva, S.A.R. Are metabolic syndrome and its components associated with 5-year mortality in chronic obstructive pupmonary disease patients? Metab. Syndr. Relat. Disord., 2015, 13(1), 52-54.
[http://dx.doi.org/10.1089/met.2014.0100] [PMID: 25353094]
[50]
Xuan, L.; Han, F.; Gong, L.; Lv, Y.; Wan, Z.; Liu, H.; Zhang, D.; Jia, Y.; Yang, S.; Ren, L.; Liu, L. Association between chronic obstructive pulmonary disease and serum lipid levels: A meta-analysis. Lipids Health Dis., 2018, 17(1), 263.
[http://dx.doi.org/10.1186/s12944-018-0904-4] [PMID: 30463568]
[51]
Lee, H.Y.; Yang, H.K.; Song, H.J.; Chang, H.J.; Kang, J.Y.; Lee, S.H.; Han, S.; Kim, Y.K. Metabolic health is more closely associated with decrease in lung function than obesity. PLoS One, 2019, 14(1), e0209575.
[http://dx.doi.org/10.1371/journal.pone.0209575] [PMID: 30673715]
[52]
Stelmach-Mardas, M.; Walkowiak, J. Dietary interventions and changes in cardio-metabolic parameters in metabolically healthy obese subjects: A systematic review with meta-analysis. Nutrients, 2016, 8(8), E455.
[http://dx.doi.org/10.3390/nu8080455] [PMID: 27483307]
[53]
Leone, N.; Courbon, D.; Thomas, F.; Bean, K.; Jégo, B.; Leynaert, B.; Guize, L.; Zureik, M. Lung function impairment and metabolic syndrome: The critical role of abdominal obesity. Am. J. Respir. Crit. Care Med., 2009, 179(6), 509-516.
[http://dx.doi.org/10.1164/rccm.200807-1195OC] [PMID: 19136371]
[54]
Sonoda, N.; Morimoto, A.; Tatsumi, Y.; Asayama, K.; Ohkubo, T.; Izawa, S.; Ohno, Y. The association between glycemic control and lung function impairment in individuals with diabetes: The Saku study. Diabetol. Int., 2018, 10(3), 213-218.
[http://dx.doi.org/10.1007/s13340-018-0382-y] [PMID: 31275788]
[55]
Lee, Y.Y.; Tsao, Y.C.; Yang, C.K.; Chuang, C.H.; Yu, W.; Chen, J.C.; Li, W.C. Association between risk factors of metabolic syndrome with lung function. Eur. J. Clin. Nutr., 2020, 74(5), 811-817.
[http://dx.doi.org/10.1038/s41430-018-0369-6] [PMID: 31427761]
[56]
Scarlata, S.; Pedone, C.; Fimognari, F.L.; Bellia, V.; Forastiere, F.; Incalzi, R.A. Restrictive pulmonary dysfunction at spirometry and mortality in the elderly. Respir. Med., 2008, 102(9), 1349-1354.
[http://dx.doi.org/10.1016/j.rmed.2008.02.021] [PMID: 18599282]

Rights & Permissions Print Cite
Article Metrics
12
1
© 2024 Bentham Science Publishers | Privacy Policy