International journal of chronic obstructive pulmonary disease · 2026
Association of Low Weight-Adjusted Muscle Mass with the Frequent Exacerbation Phenotype in COPD: A Retrospective Cross-Sectional Study.
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Zhang Yunfeng, Xu Cheng, Jiang Xinhao, Qu Ling, Chen Zhouwei, Cheng Qing, Xu Xianghuai
Аннотация
PURPOSE: Traditional height-adjusted muscle mass index (ASMI) may be influenced by weight loss in advanced COPD. This study compared the associations of ASMI and appendicular skeletal muscle mass-to-body mass index ratio (ASM/BMI) with the frequent exacerbation phenotype, assessed whether the ASM/BMI association differed by BMI category, and evaluated the discriminative performance of ASM/BMI.
PATIENTS AND METHODS: This retrospective cross-sectional study included 419 patients with COPD. Body composition was measured using multifrequency bioelectrical impedance analysis. Multivariable logistic regression and subgroup interaction analyses were used to evaluate the independent associations of ASMI and ASM/BMI with the frequent exacerbation phenotype (≥2 moderate or ≥1 severe exacerbations in the preceding year).
RESULTS: Low ASMI was not significantly associated with the frequent exacerbation phenotype (adjusted OR [aOR], 1.52; 95% CI, 0.96-2.41). Low ASM/BMI was significantly associated with this phenotype (aOR, 1.74; 95% CI, 1.07-2.87). This association was modified by BMI (Pinteraction = 0.005). Among patients with a BMI < 24 kg/m2, the association between low ASM/BMI and the frequent exacerbation phenotype was strongest (aOR, 5.66; 95% CI, 2.22-17.66). This association was not observed in patients with a BMI ≥ 24 kg/m2 (aOR, 1.00; 95% CI, 0.51-1.97).
CONCLUSION: In COPD, muscle mass should be interpreted in the context of body weight. Low ASM/BMI was strongly associated with the frequent exacerbation phenotype specifically among patients with a BMI < 24 kg/m2. These findings support further evaluation of ASM/BMI as a complementary body-composition marker in this subgroup rather than as a standalone discriminative tool.
PATIENTS AND METHODS: This retrospective cross-sectional study included 419 patients with COPD. Body composition was measured using multifrequency bioelectrical impedance analysis. Multivariable logistic regression and subgroup interaction analyses were used to evaluate the independent associations of ASMI and ASM/BMI with the frequent exacerbation phenotype (≥2 moderate or ≥1 severe exacerbations in the preceding year).
RESULTS: Low ASMI was not significantly associated with the frequent exacerbation phenotype (adjusted OR [aOR], 1.52; 95% CI, 0.96-2.41). Low ASM/BMI was significantly associated with this phenotype (aOR, 1.74; 95% CI, 1.07-2.87). This association was modified by BMI (Pinteraction = 0.005). Among patients with a BMI < 24 kg/m2, the association between low ASM/BMI and the frequent exacerbation phenotype was strongest (aOR, 5.66; 95% CI, 2.22-17.66). This association was not observed in patients with a BMI ≥ 24 kg/m2 (aOR, 1.00; 95% CI, 0.51-1.97).
CONCLUSION: In COPD, muscle mass should be interpreted in the context of body weight. Low ASM/BMI was strongly associated with the frequent exacerbation phenotype specifically among patients with a BMI < 24 kg/m2. These findings support further evaluation of ASM/BMI as a complementary body-composition marker in this subgroup rather than as a standalone discriminative tool.