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Body composition, energy expenditure and physical activity

Clinical impact of body composition phenotypes in patients with COPD: a retrospective analysis



Abnormal body composition is an independent determinant of COPD outcomes. To date, it is already known that patient stratification into body composition phenotypes are associated with important outcomes, such as exercise capacity and inflammation, but there are no data comparing physical activity and muscle strength among these phenotypes. Thus, the aim of this study was to compare clinical characteristics and physical function in patients with COPD stratified into body composition phenotypes.


Two-hundred and seventy stable COPD patients were classified according to the 10th and 90th percentiles of sex-age-BMI-specific reference values for fat-free and fat mass indexes into four groups: Normal body composition (NBC), Obese, Sarcopenic, and Sarcopenic-obese (SO). Patients underwent assessment of exercise capacity, peripheral and respiratory muscle strength, physical activity, dyspnea severity, functional status, and symptoms of anxiety and depression.


The prevalence of patients classified as NBC, Obese, Sarcopenic, and SO was 39%, 13%, 21%, or 27%, respectively. SO presented lower 6MWT compared with NBC (P < 0.05). Sarcopenic and SO groups presented worse muscle strength compared with NBC (P < 0.05). Sarcopenic group presented more time in moderate-to-vigorous physical activity compared to all other groups (P < 0.05) and less sedentary time when compared with NBC and obese groups (P < 0.05). There were no differences regarding dyspnea severity, functional status, and symptoms of anxiety and depression (P > 0.16). Sarcopenic and SO groups had, respectively, 7.8 [95% CI: 1.6–37.7] and 9.5 [2.2–41.7] times higher odds to have a 6MWT equal or lower to 350 meters.


Body composition phenotypes are associated with physical function in patients with COPD. Sarcopenic-obese patients were the most impaired.

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We are grateful to the colleagues of the Laboratory of Research in Respiratory Physiotherapy for the contribution to the study. In addition, we acknowledge, the patients who participated in the study and the support of CAPES and CNPq, Brazil.

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Correspondence to Nidia A. Hernandes.

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Machado, F.V.C., Schneider, L.P., Fonseca, J. et al. Clinical impact of body composition phenotypes in patients with COPD: a retrospective analysis. Eur J Clin Nutr 73, 1512–1519 (2019).

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