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Article ; Online: Insomnia in chronic obstructive pulmonary disease and associations with healthcare utilization and costs.

Luyster, Faith S / Boudreaux-Kelly, Monique Y / Bon, Jessica M

2023 Volume 24, Issue 1, Page(s) 93

Abstract: Insomnia has been linked to adverse chronic obstructive pulmonary disease (COPD) outcomes including exacerbations, yet its impact on COPD-related healthcare utilization and costs is unknown. In this study, we investigated the associations between ... ...

Abstract	Insomnia has been linked to adverse chronic obstructive pulmonary disease (COPD) outcomes including exacerbations, yet its impact on COPD-related healthcare utilization and costs is unknown. In this study, we investigated the associations between insomnia and healthcare utilization and costs in patients with COPD. A retrospective cohort of veterans with COPD were identified from national Veterans Affairs administration data for fiscal years 2012-2017. Insomnia was operationalized as having an insomnia diagnosis based on International Classification of Disease codes or having a prescription of > 30 doses of a sedative-hypnotic medication in a given fiscal year. The index date for insomnia was the first date when dual criteria for COPD and insomnia was met. The index date for those without insomnia was set as the COPD index date. Our primary outcomes were 1-year healthcare utilization and costs related to outpatient visits and hospitalizations after index date. COPD-related healthcare utilization variables included number of prescription fills of corticosteroids and/or antibiotics and outpatient visits and hospitalizations with a primary diagnosis of COPD. Out of 1,011,646 patients (96% men, mean age 68.4 years) diagnosed with COPD, 407,363 (38.8%) had insomnia. After adjustment for confounders, insomnia was associated with higher rates of outpatient visits, hospitalizations, and fills for corticosteroids and/or antibiotics, longer hospital length of stay, and $10,344 higher hospitalization costs in the 12 months after index date. These findings highlight the importance of insomnia as a potentially modifiable target for reducing the burden of COPD on patients and healthcare systems.
MeSH term(s)	Male ; Humans ; Aged ; Female ; Retrospective Studies ; Sleep Initiation and Maintenance Disorders/diagnosis ; Sleep Initiation and Maintenance Disorders/drug therapy ; Sleep Initiation and Maintenance Disorders/epidemiology ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Pulmonary Disease, Chronic Obstructive/drug therapy ; Pulmonary Disease, Chronic Obstructive/epidemiology ; Delivery of Health Care ; Adrenal Cortex Hormones/therapeutic use ; Patient Acceptance of Health Care
Chemical Substances	Adrenal Cortex Hormones
Language	English
Publishing date	2023-03-25
Publishing country	England
Document type	Letter
ZDB-ID	2041675-1
ISSN	1465-993X ; 1465-993X
ISSN (online)	1465-993X
ISSN	1465-993X
DOI	10.1186/s12931-023-02401-w
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Article: Morpho-Functional Traits Reveal Differences in Size Fractionated Phytoplankton Communities but Do Not Significantly Affect Zooplankton Grazing.

Titocci, Jessica / Bon, Melanie / Fink, Patrick

Microorganisms

2022 Volume 10, Issue 1

Abstract: The recent emergence of approaches based on functional traits allows a more comprehensive evaluation of the role of functions and interactions within communities. As phytoplankton size and shape are the major determinants of its edibility to herbivores, ... ...

Abstract	The recent emergence of approaches based on functional traits allows a more comprehensive evaluation of the role of functions and interactions within communities. As phytoplankton size and shape are the major determinants of its edibility to herbivores, alteration or loss of some morpho-functional phytoplankton traits should affect zooplankton grazing, fitness and population dynamics. Here, we investigated the response of altered phytoplankton morpho-functional trait distribution to grazing by zooplankton with contrasting food size preferences and feeding behaviors. To test this, we performed feeding trials in laboratory microcosms with size-fractionated freshwater phytoplankton (3 size classes, >30 µm; 5-30 µm and <5 µm) and two different consumer types: the cladoceran
Language	English
Publishing date	2022-01-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2720891-6
ISSN	2076-2607
ISSN	2076-2607
DOI	10.3390/microorganisms10010182
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Article ; Online: Association of Systemic Inflammation with Depressive Symptoms in Individuals with COPD.

Strollo, Hilary C / Nouraie, Seyed M / Hoth, Karin F / Riley, Craig M / Karoleski, Chad / Zhang, Yingze / Hanania, Nicola A / Bowler, Russell P / Bon, Jessica / Sciurba, Frank C

International journal of chronic obstructive pulmonary disease

2021 Volume 16, Page(s) 2515–2522

Abstract: Rationale: Depression is a prevalent comorbidity of chronic obstructive pulmonary disease (COPD) that, along with COPD, has been associated with inflammation. An association between inflammation and depression in COPD has not been validated in a large ... ...

Abstract	Rationale: Depression is a prevalent comorbidity of chronic obstructive pulmonary disease (COPD) that, along with COPD, has been associated with inflammation. An association between inflammation and depression in COPD has not been validated in a large COPD cohort. Methods: Individuals from the University of Pittsburgh SCCOR cohort and the COPDGene cohort with tobacco use history and airway obstruction (FEV Results: The SCCOR cohort included 220 obstructed participants: 44% female and 21.4% with elevated depressive symptoms. GOLD staging distribution was predominantly stage I and II. The COPDGene cohort included 745 obstructed participants: 44% female and 13.0% with elevated depressive symptoms. GOLD distribution was predominantly stage II and III. In the SCCOR cohort, correlation between IL-6 and depressive symptoms trended toward significance (p= 0.08). Multivariable modeling adjusted for FEV Conclusion: Elevated plasma IL-6 levels are associated with depressive symptoms in individuals with COPD independent of airflow limitation and comorbid risk factors for depression. Our results suggest that systemic inflammation may play a significant and possibly bidirectional role in depression associated with COPD.
MeSH term(s)	Cohort Studies ; Comorbidity ; Depression/diagnosis ; Depression/epidemiology ; Female ; Humans ; Inflammation/diagnosis ; Inflammation/epidemiology ; Male ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Pulmonary Disease, Chronic Obstructive/epidemiology
Language	English
Publishing date	2021-09-03
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2212419-6
ISSN	1178-2005 ; 1176-9106
ISSN (online)	1178-2005
ISSN	1176-9106
DOI	10.2147/COPD.S322144
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Article ; Online: Macrobenthic communities in a shallow normoxia to hypoxia gradient in the Humboldt upwelling ecosystem.

Fajardo, Maritza / Andrade, Diego / Bonicelli, Jessica / Bon, Melanie / Gómez, Gonzalo / Riascos, José M / Pacheco, Aldo S

PloS one

2018 Volume 13, Issue 7, Page(s) e0200349

Abstract: ... m-for two years to understand how hypoxia affects the structure of shallow communities at two sites ... depths of 20 to 10 m. Only one episode of oxygenation was detected in June 2016, where normoxia (>2ml/l ... O2) reached down to 50 m. The structure of the communities depicted a clear pattern of increasing ...

Abstract	Hypoxia is one of the most important stressors affecting the health conditions of coastal ecosystems. In highly productive ecosystems such as the Humboldt Current ecosystem, the oxygen minimum zone is an important abiotic factor modulating the structure of benthic communities over the continental shelf. Herein, we study soft-bottom macrobenthic communities along a depth gradient-at 10, 20, 30 and 50 m-for two years to understand how hypoxia affects the structure of shallow communities at two sites in Mejillones Bay (23°S) in northern Chile. We test the hypothesis that, during months with shallow hypoxic zones, community structure will be much more dissimilar, thereby depicting a clear structural gradient with depth and correlated abiotic variables (e.g. organic matter, temperature and salinity). Likewise, during conditions of deeper hypoxic zones, communities will be similar among habitats as they could develop structure via succession in conditions with less stress. Throughout the sampling period (October 2015 to October 2017), the water column was hypoxic (from 2 to 0.5ml/l O2) most of the time, reaching shallow depths of 20 to 10 m. Only one episode of oxygenation was detected in June 2016, where normoxia (>2ml/l O2) reached down to 50 m. The structure of the communities depicted a clear pattern of increasing dissimilarity from shallow normoxic and deep hypoxic habitat. This pattern was persistent throughout time despite the occurrence of an oxygenation episode. Contrasting species abundance and biomass distribution explained the gradient in structure, arguably reflecting variable levels of hypoxia adaptation, i.e. few polychaetes such as Magelona physilia and Paraprionospio pinnata were only located in low oxygen habitats. The multivariable dispersion of community composition as a proxy of beta diversity decreased significantly with depth, suggesting loss of community structure and variability when transitioning from normoxic to hypoxic conditions. Our results show the presence of semi-permanent shallow hypoxia at Mejillones Bay, constraining diverse and more variable communities at a very shallow depth (10-20 m). These results must be considered in the context of the current decline of dissolved oxygen in most oceans and coastal regions and their impact on seabed biota.
MeSH term(s)	Animals ; Chile ; Ecosystem ; Invertebrates/metabolism ; Oxygen/metabolism ; Pacific Ocean ; Salts/metabolism ; Stress, Physiological ; Temperature ; Time Factors ; Water/metabolism
Chemical Substances	Salts ; Water (059QF0KO0R) ; Oxygen (S88TT14065)
Language	English
Publishing date	2018-07-17
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0200349
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Article ; Online: Clinical Markers Associated With Risk of Suicide or Drug Overdose Among Individuals With Smoking Exposure: A Longitudinal Follow-up Study of the COPDGene Cohort.

Adviento, Brigid A / Regan, Elizabeth A / Make, Barry J / Han, MeiLan K / Foreman, Marilyn G / Iyer, Anand S / Bhatt, Surya P / Kim, Victor / Bon, Jessica / Soler, Xavier / Kinney, Gregory L / Hanania, Nicola A / Lowe, Katherine E / Holm, Kristen E / Yohannes, Abebaw M / Shinozaki, Gen / Hoth, Karin F / Fiedorowicz, Jess G

Chest

2022 Volume 163, Issue 2, Page(s) 292–302

Abstract: Background: Studies have shown that COPD and smoking are associated with increased suicide risk. To date, there are no prospective studies examining suicide risk among individuals with smoking exposure along a spectrum of pulmonary diseases ranging from ...

Abstract	Background: Studies have shown that COPD and smoking are associated with increased suicide risk. To date, there are no prospective studies examining suicide risk among individuals with smoking exposure along a spectrum of pulmonary diseases ranging from normal spirometry to severe COPD. Research question: Which clinical variables predict death by suicide or overdose of indeterminate intent in a large cohort of individuals with smoking exposure within the Genetic Epidemiology of COPD (COPDGene) study? Study design and methods: We studied data from 9,930 participants involved in COPDGene, a multisite, prospective cohort study of individuals with smoking exposure. Primary cause of adjudicated deaths was identified by using death certificates, family reports, and medical records. Time to death by suicide/overdose was examined as the primary outcome in Cox regression models including age, sex, race, BMI, pack-years, current smoking status, airflow limitation (FEV Results: The cohort was 47% female and 33% Black (67% White); they had a mean ± SD age of 59.6 ± 9.0 years and a mean FEV Interpretation: In this well-characterized cohort of individuals with smoking exposure with and without COPD, risk factors for suicide/overdose were identified that emphasize the subjective experience of illness over objective assessments of lung function.
MeSH term(s)	Humans ; Female ; Middle Aged ; Aged ; Male ; Follow-Up Studies ; Pulmonary Disease, Chronic Obstructive ; Prospective Studies ; Smoking/adverse effects ; Smoking/epidemiology ; Risk Factors ; Dyspnea ; Biomarkers ; Drug Overdose ; Forced Expiratory Volume
Chemical Substances	Biomarkers
Language	English
Publishing date	2022-09-24
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1032552-9
ISSN	1931-3543 ; 0012-3692
ISSN (online)	1931-3543
ISSN	0012-3692
DOI	10.1016/j.chest.2022.09.022
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Article ; Online: Increased chest CT derived bone and muscle measures capture markers of improved morbidity and mortality in COPD.

Wilson, Ava C / Bon, Jessica M / Mason, Stephanie / Diaz, Alejandro A / Lutz, Sharon M / Estepar, Raul San Jose / Kinney, Gregory L / Hokanson, John E / Rennard, Stephen I / Casaburi, Richard / Bhatt, Surya P / Irvin, Marguerite R / Hersh, Craig P / Dransfield, Mark T / Washko, George R / Regan, Elizabeth A / McDonald, Merry-Lynn

Respiratory research

2022 Volume 23, Issue 1, Page(s) 311

Abstract: Background: Chronic obstructive pulmonary disease (COPD) is a disease of accelerated aging and is associated with comorbid conditions including osteoporosis and sarcopenia. These extrapulmonary conditions are highly prevalent yet frequently ... ...

Abstract	Background: Chronic obstructive pulmonary disease (COPD) is a disease of accelerated aging and is associated with comorbid conditions including osteoporosis and sarcopenia. These extrapulmonary conditions are highly prevalent yet frequently underdiagnosed and overlooked by pulmonologists in COPD treatment and management. There is evidence supporting a role for bone-muscle crosstalk which may compound osteoporosis and sarcopenia risk in COPD. Chest CT is commonly utilized in COPD management, and we evaluated its utility to identify low bone mineral density (BMD) and reduced pectoralis muscle area (PMA) as surrogates for osteoporosis and sarcopenia. We then tested whether BMD and PMA were associated with morbidity and mortality in COPD. Methods: BMD and PMA were analyzed from chest CT scans of 8468 COPDGene participants with COPD and controls (smoking and non-smoking). Multivariable regression models tested the relationship of BMD and PMA with measures of function (6-min walk distance (6MWD), handgrip strength) and disease severity (percent emphysema and lung function). Multivariable Cox proportional hazards models were used to evaluate the relationship between sex-specific quartiles of BMD and/or PMA derived from non-smoking controls with all-cause mortality. Results: COPD subjects had significantly lower BMD and PMA compared with controls. Higher BMD and PMA were associated with increased physical function and less disease severity. Participants with the highest BMD and PMA quartiles had a significantly reduced mortality risk (36% and 46%) compared to the lowest quartiles. Conclusions: These findings highlight the potential for CT-derived BMD and PMA to characterize osteoporosis and sarcopenia using equipment available in the pulmonary setting.
MeSH term(s)	Humans ; Male ; Female ; Sarcopenia/diagnostic imaging ; Sarcopenia/epidemiology ; Hand Strength ; Pulmonary Disease, Chronic Obstructive ; Osteoporosis/diagnostic imaging ; Osteoporosis/epidemiology ; Osteoporosis/complications ; Tomography, X-Ray Computed/adverse effects ; Morbidity ; Muscles ; Bone Density
Language	English
Publishing date	2022-11-15
Publishing country	England
Document type	Letter
ZDB-ID	2041675-1
ISSN	1465-993X ; 1465-993X
ISSN (online)	1465-993X
ISSN	1465-993X
DOI	10.1186/s12931-022-02237-w
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Article ; Online: Vitamin D deficiency is associated with respiratory symptoms and airway wall thickening in smokers with and without COPD: a prospective cohort study.

Ghosh, Auyon J / Moll, Matthew / Hayden, Lystra P / Bon, Jessica / Regan, Elizabeth / Hersh, Craig P

BMC pulmonary medicine

2020 Volume 20, Issue 1, Page(s) 123

Abstract: Background: Previous studies have established a higher prevalence of vitamin D deficiency in patients with COPD, but the relationship between vitamin D levels and COPD exacerbations remains controversial. In addition, the effect of vitamin D levels on ... ...

Abstract	Background: Previous studies have established a higher prevalence of vitamin D deficiency in patients with COPD, but the relationship between vitamin D levels and COPD exacerbations remains controversial. In addition, the effect of vitamin D levels on imaging characteristics remains mostly unexplored. Using cross-sectional and longitudinal follow up data from the COPDGene Study, we assessed the association between vitamin D levels on respiratory symptoms, exacerbations, and imaging characteristics. We hypothesized that vitamin D deficiency will be associated with worse respiratory-related outcomes. Methods: Current and former smokers between ages 45-80 were enrolled the COPDGene Study. Subjects completed questionnaires, spirometry, six-minute walk test, and chest computed tomography scans. A subset of subjects had measurement of serum concentration of 25-hydroxyvitamin D (25(OH)D). Vitamin D deficiency was defined as serum concentration less than 20 ng/mL. Longitudinal follow up was conducted via a web-based or telephone questionnaire. Results: Vitamin D levels were measured on 1544 current and former smokers, of which 981 subjects had sufficient vitamin D levels and 563 subjects had vitamin D deficiency. Subjects with vitamin D deficiency were younger with increased likelihood of being African American, being current smokers, having a lower percent predicted FEV Conclusion: Vitamin D deficiency was associated with increased respiratory symptoms, decreased functional status, increased frequency of severe exacerbations, as well as airway wall thickening on chest CT scans. Further research is needed to determine the potential impact of vitamin D supplementation to improve disease outcomes.
MeSH term(s)	Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Female ; Humans ; Linear Models ; Lung/physiopathology ; Male ; Middle Aged ; Multivariate Analysis ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive/blood ; Pulmonary Disease, Chronic Obstructive/complications ; Pulmonary Disease, Chronic Obstructive/epidemiology ; Quality of Life ; Respiratory Function Tests ; Severity of Illness Index ; Smokers ; Spirometry ; Surveys and Questionnaires ; United States/epidemiology ; Vitamin D/analogs & derivatives ; Vitamin D/blood ; Vitamin D Deficiency/blood ; Vitamin D Deficiency/complications ; Vitamin D Deficiency/epidemiology ; Walk Test
Chemical Substances	Vitamin D (1406-16-2) ; 25-hydroxyvitamin D (A288AR3C9H)
Language	English
Publishing date	2020-05-04
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Observational Study
ZDB-ID	2059871-3
ISSN	1471-2466 ; 1471-2466
ISSN (online)	1471-2466
ISSN	1471-2466
DOI	10.1186/s12890-020-1148-4
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Article ; Online: Phenotypes, Etiotypes, and Endotypes of Exacerbations of Chronic Obstructive Pulmonary Disease.

Bhatt, Surya P / Agusti, Alvar / Bafadhel, Mona / Christenson, Stephanie A / Bon, Jessica / Donaldson, Gavin C / Sin, Don D / Wedzicha, Jadwiga A / Martinez, Fernando J

American journal of respiratory and critical care medicine

2023 Volume 208, Issue 10, Page(s) 1026–1041

Abstract: Chronic obstructive pulmonary disease is a major health problem with a high prevalence, a rising incidence, and substantial morbidity and mortality. Its course is punctuated by acute episodes of increased respiratory symptoms, termed exacerbations of ... ...

Abstract	Chronic obstructive pulmonary disease is a major health problem with a high prevalence, a rising incidence, and substantial morbidity and mortality. Its course is punctuated by acute episodes of increased respiratory symptoms, termed exacerbations of chronic obstructive pulmonary disease (ECOPD). ECOPD are important events in the natural history of the disease, as they are associated with lung function decline and prolonged negative effects on quality of life. The present-day therapy for ECOPD with short courses of antibiotics and steroids and escalation of bronchodilators has resulted in only modest improvements in outcomes. Recent data indicate that ECOPD are heterogeneous, raising the need to identify distinct etioendophenotypes, incorporating traits of the acute event and of patients who experience recurrent events, to develop novel and targeted therapies. These characterizations can provide a complete clinical picture, the severity of which will dictate acute pharmacological treatment, and may also indicate whether a change in maintenance therapy is needed to reduce the risk of future exacerbations. In this review we discuss the latest knowledge of ECOPD types on the basis of clinical presentation, etiology, natural history, frequency, severity, and biomarkers in an attempt to characterize these events.
MeSH term(s)	Humans ; Quality of Life ; Disease Progression ; Pulmonary Disease, Chronic Obstructive ; Anti-Bacterial Agents/therapeutic use ; Phenotype
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2023-08-09
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	1180953-x
ISSN	1535-4970 ; 0003-0805 ; 1073-449X
ISSN (online)	1535-4970
ISSN	0003-0805 ; 1073-449X
DOI	10.1164/rccm.202209-1748SO
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Article ; Online: Incident low muscle mass is associated with greater lung disease and lower circulating leptin in a tobacco-exposed longitudinal cohort.

Zou, Richard H / Nouraie, S Mehdi / Karoleski, Chad / Zhang, Yingze / Sciurba, Frank C / Forman, Daniel E / Bon, Jessica

Respiratory research

2023 Volume 24, Issue 1, Page(s) 224

Abstract: ... muscle mass (LM) at follow-up were characterized by FFMI < 18.4 kg/m: Results: Twenty-five (10 ... active smoking prevalence (60% v. 38%, p = 0.04), lower FFMI (17.8 ± 1.7 kg/m: Conclusions ...

Abstract	Background: Muscle loss is prevalent in chronic obstructive pulmonary disease (COPD). Prior studies evaluating musculoskeletal dysfunction in COPD have focused on individuals with baseline low muscle mass. Currently, there is limited data evaluating clinical characteristics and outcomes associated with progression to incident low muscle mass in a tobacco-exposed cohort of individuals with baseline normal muscle mass. Methods: We evaluated 246 participants from a single-center longitudinal tobacco-exposed cohort with serial spirometry, thoracic imaging, dual energy x-ray absorptiometry (DXA) measurements, walk testing, and plasma adipokine measurements. DXA-derived fat free mass index (FFMI) and appendicular skeletal mass index (ASMI) were used as surrogates for muscle mass. Participants with incident low muscle mass (LM) at follow-up were characterized by FFMI < 18.4 kg/m Results: Twenty-five (10%) participants progressed to incident low muscle mass at follow-up. At baseline, the LM subgroup had greater active smoking prevalence (60% v. 38%, p = 0.04), lower FFMI (17.8 ± 1.7 kg/m Conclusions: We identified a subgroup of tobacco-exposed individuals with normal baseline muscle mass who progressed to incident DXA-derived low muscle mass. This subgroup demonstrated synchronous lung disease and persistently low circulating leptin levels. Our study suggests the importance of assessing for muscle loss in conjunction with lung function decline when evaluating individuals with tobacco exposure.
MeSH term(s)	Female ; Male ; Humans ; Leptin ; Pulmonary Disease, Chronic Obstructive ; Smoking ; Muscles
Chemical Substances	Leptin
Language	English
Publishing date	2023-09-22
Publishing country	England
Document type	Journal Article
ZDB-ID	2041675-1
ISSN	1465-993X ; 1465-993X
ISSN (online)	1465-993X
ISSN	1465-993X
DOI	10.1186/s12931-023-02521-3
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Article ; Online: CT pectoralis muscle area is associated with DXA lean mass and correlates with emphysema progression in a tobacco-exposed cohort.

O'Brien, Michael Emmet / Zou, Richard H / Hyre, Nathan / Leader, Joseph K / Fuhrman, Carl R / Sciurba, Frank C / Nouraie, Mehdi / Bon, Jessica

Thorax

2021 Volume 78, Issue 4, Page(s) 394–401

Abstract: Introduction: Muscle loss is an important extrapulmonary manifestation of COPD. Dual energy X-ray absorptiometry (DXA) is the method of choice for body composition measurement but is not widely used for muscle mass evaluation. The pectoralis muscle area ...

Abstract	Introduction: Muscle loss is an important extrapulmonary manifestation of COPD. Dual energy X-ray absorptiometry (DXA) is the method of choice for body composition measurement but is not widely used for muscle mass evaluation. The pectoralis muscle area (PMA) is quantifiable by CT and predicts cross-sectional COPD-related morbidity. There are no studies that compare PMA with DXA measures or that evaluate longitudinal relationships between PMA and lung disease progression. Methods: Participants from our longitudinal tobacco-exposed cohort had baseline and 6-year chest CT (n=259) and DXA (n=164) data. Emphysema was quantified by CT density histogram parenchymal scoring using the 15th percentile technique. Fat-free mass index (FFMI) and appendicular skeletal mass index (ASMI) were calculated from DXA measurements. Linear regression model relationships were reported using standardised coefficient (β) with 95% CI. Results: PMA was more strongly associated with DXA measures than with body mass index (BMI) in both cross-sectional (FFMI: β=0.76 (95% CI 0.65 to 0.86), p<0.001; ASMI: β=0.76 (95% CI 0.66 to 0.86), p<0.001; BMI: β=0.36 (95% CI 0.25 to 0.47), p<0.001) and longitudinal (ΔFFMI: β=0.43 (95% CI 0.28 to 0.57), p<0.001; ΔASMI: β=0.42 (95% CI 0.27 to 0.57), p<0.001; ΔBMI: β=0.34 (95% CI 0.22 to 0.46), p<0.001) models. Six-year change in PMA was associated with 6-year change in emphysema (β=0.39 (95% CI 0.23 to 0.56), p<0.001) but not with 6-year change in airflow obstruction. Conclusions: PMA is an accessible measure of muscle mass and may serve as a useful clinical surrogate for assessing skeletal muscle loss in smokers. Decreased PMA correlated with emphysema progression but not lung function decline, suggesting a difference in the pathophysiology driving emphysema, airflow obstruction and comorbidity risk.
MeSH term(s)	Humans ; Pectoralis Muscles ; Nicotiana ; Absorptiometry, Photon ; Cross-Sectional Studies ; Emphysema ; Pulmonary Emphysema/diagnostic imaging ; Pulmonary Emphysema/etiology ; Muscle, Skeletal/diagnostic imaging ; Tomography, X-Ray Computed/methods
Language	English
Publishing date	2021-12-01
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	204353-1
ISSN	1468-3296 ; 0040-6376
ISSN (online)	1468-3296
ISSN	0040-6376
DOI	10.1136/thoraxjnl-2021-217710
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