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Clinical Nutrition

Fat-free mass depletion in patients with COPD in Brazil: development of a new cutoff point and its relation with mortality and extrapulmonary manifestations

European Journal of Clinical Nutrition volume 71, pages 1285–1290 (2017)Cite this article

Subjects

Abstract

Background/Objectives:

None of the cutoff points for fat-free mass index (FFMI) were tested for the Brazilian population, and it is unknown whether the available ones are able to discriminate extrapulmonary disease manifestations. This cross-sectional study aims to develop and validate a cutoff point for FFM depletion based on Brazilian patients with chronic obstructive pulmonary disease (COPD) and to verify its association and of previously published cutoffs with extrapulmonary manifestations.

Subjects/Methods:

A new cutoff point was obtained from the best FFMI value for discrimination of preserved exercise capacity in a sample of patients (n=57). The discriminative capacity was assessed in another sample (n=96). The new cutoff point and other previously published ones were tested to discriminate low exercise capacity, physical inactivity, sedentary lifestyle and low quality of life. A receiver operation characteristics curve with area under the curve (AUC) value was plotted and each cutoff points’ discriminative capacity was calculated. Cox regression and Kaplan–Meier method assessed the association between the cutoff points and mortality.

Results:

The new cutoff points for FFMI were 14.65 kg/m2 for women (AUC=0.744; sensitivity (Se)=0.88; specificity (Sp)=0.60) and 20.35 kg/m2 for men (AUC=0.565; Se=0.36; Sp=0.81). The new cutoffs were the best to discriminate poor exercise capacity assessed by walked distance in % predicted and quality of life. Only the new cutoff point was associated with mortality (HR=2.123; 95% CI: 1.03–4.33, P=0.039, log rank P=0.035).

Conclusions:

Only the new cutoff point was associated with all-cause mortality, and it had the highest discriminating capacity for exercise capacity and quality of life in Brazilian patients with COPD.

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Acknowledgements

We are grateful to the colleagues from the Laboratory of Research in Respiratory Physiotherapy and to Postgraduate programme in Rehabilitation Sciences UEL-UNOPAR. The project was supported by Araucaria Foundation (Paraná, Brazil). AT, AR, KCF, LD, GWB and AN are supported by grants from Coordination for the Improvement of Higher Education Personnel (CAPES, Brazil). FP is supported by a research grant from National Council for Scientific and Technological Development (CNPq, Brazil).

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Authors and Affiliations

  1. Department of Physiotherapy, Laboratory of Research in Respiratory Physiotherapy (LFIP), State University of Londrina (UEL), Londrina, Brazil

    A Travassos, A Rodrigues, K C Furlanetto, L Donária, G W Bisca, A G Nellessen, F Pitta & N A Hernandes

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  1. A Travassos
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Correspondence to F Pitta.

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Travassos, A., Rodrigues, A., Furlanetto, K. et al. Fat-free mass depletion in patients with COPD in Brazil: development of a new cutoff point and its relation with mortality and extrapulmonary manifestations. Eur J Clin Nutr 71, 1285–1290 (2017). https://doi.org/10.1038/ejcn.2017.105

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