ILD Associated With More Muscle Mass, Less Bone Density Loss

Doctor reviewing bone density scan
Researchers of the study aimed to determine the differences in muscle area and bone density in patients with end-stage lung disease.

This article is part of Pulmonology Advisor‘s coverage of the CHEST 2019 meeting, taking place in New Orleans, LA. Our staff will report on medical research related to asthma, COPD, critical care medicine, and more conducted by experts in the field. Check back regularly for more news from CHEST 2019.

NEW ORLEANS — Compared with patients with chronic obstructive pulmonary disease (COPD), patients with interstitial lung disease (ILD) may demonstrate higher pectoralis muscle area (PMA) and less bone density loss, according to study results presented at CHEST Annual Meeting 2019, held October 19 to 23, 2019, in New Orleans, Louisiana.

Researchers of the study aimed to determine the differences in muscle mass and bone density in patients with end-stage lung disease.

The single-center retrospective study cohort included adult patients who were candidates for lung transplant. Researchers evaluated information collected from patient demographic and clinical data, the 6-minute walk test, and images from dual-energy absorptiometry and chest computed tomography (CT). Two independent reviewers measured PMA from the chest CT, with the help of image analysis software. Pectoralis muscle index (PMI) and T score were also calculated. The researchers also measured PMA in a subset of the study population.

Of the 236 patients who were lung transplant candidates, 123 (52.1%) had ILD, 43 (18.2%) had COPD, 31 (13.1%) had cystic fibrosis, and 16 (6.8%) had pulmonary hypertension. Sixteen patients had other diseases, including sarcoidosis and an overlap of COPD and ILD.

Results showed that compared with patients with COPD, patients with ILD had significantly greater PMA (25.0±9.0 cm2 vs 17.7±7.4 cm2; P =.0003) and PMI (8.5±2.8 cm2/m2 vs 6.1±2.3 cm2/m2; P =.0001). In addition, PMA was greater in patients with normal bone density vs those with osteopenia and osteoporosis (29.5±9.5 cm2 vs 21.8±7.6 cm2 and 17.8±6.9 cm2, respectively; P <.001).

Compared with patients with ILD, patients with COPD and cystic fibrosis had significantly worse bone density (P <.001).

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“A better understanding of the mechanisms underlying these changes may help to prevent bone and muscle loss in patients with obstructive lung disease,” the researchers concluded.

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Wang T, Li G, Kao C, Parulekar A. Bone and muscle loss in patients with end-stage lung disease. Presented at: CHEST 2019 Annual Meeting; October 19-23, 2019; New Orleans, LA. Abstract 1588.