Antigravity muscle density on computed tomography and health-related independence in normal weight patients with chronic obstructive pulmonary disease

Abstract Background Low body mass index (BMI) is a prognostic factor, and skeletal muscle adiposity may affect mortality irrespective of BMI in patients with chronic obstructive pulmonary disease (COPD). However, the association between muscle adiposity and healthy life expectancy in normal-weight p...

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Main Authors: Satoru Terada, Naoya Tanabe, Tomoki Maetani, Yusuke Shiraishi, Kunihiko Terada, Hiroshi Shima, Tsuyoshi Oguma, Ryo Sakamoto, Megumi Kanasaki, Izuru Masuda, Atsuyasu Sato, Susumu Sato, Toyohiro Hirai
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Language:English
Published: BMC 2025-04-01
Series:Respiratory Research
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Online Access:https://doi.org/10.1186/s12931-025-03211-y
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author Satoru Terada
Naoya Tanabe
Tomoki Maetani
Yusuke Shiraishi
Kunihiko Terada
Hiroshi Shima
Tsuyoshi Oguma
Ryo Sakamoto
Megumi Kanasaki
Izuru Masuda
Atsuyasu Sato
Susumu Sato
Toyohiro Hirai
author_facet Satoru Terada
Naoya Tanabe
Tomoki Maetani
Yusuke Shiraishi
Kunihiko Terada
Hiroshi Shima
Tsuyoshi Oguma
Ryo Sakamoto
Megumi Kanasaki
Izuru Masuda
Atsuyasu Sato
Susumu Sato
Toyohiro Hirai
author_sort Satoru Terada
collection DOAJ
description Abstract Background Low body mass index (BMI) is a prognostic factor, and skeletal muscle adiposity may affect mortality irrespective of BMI in patients with chronic obstructive pulmonary disease (COPD). However, the association between muscle adiposity and healthy life expectancy in normal-weight patients remains unestablished. Objective To examine whether lower chest computed tomography (CT)-assessed erector spinae muscle density (ESMD), which represents antigravity muscle adiposity, is associated with subsequent loss of health-related independence in normal-weight patients with COPD. Methods The ESMD lower limit of normal (LLN) was determined in 194 healthy subjects undergoing lung cancer screening CT. In a prospective cohort of patients with COPD undergoing baseline inspiratory/expiratory CT, the onset of loss of health-related independence, requiring long-term nursing facility or home nursing/medical care, was recorded over 5 years. Results Smokers with COPD (n = 199) were divided into 4 groups on the basis of BMI and the ESMD–LLN: underweight (n = 22), normal-weight with (n = 40) and without (n = 81) low ESMD, and overweight (n = 56). Greater airway wall thickening was associated with BMI-independent low ESMD. A multivariable Cox proportional hazards model including only normal-weight patients with COPD (n = 121) indicated that low ESMD was independently associated with a higher loss-of-independence rate after adjusting for FEV1, COPD assessment test score, and a smaller cross-sectional area of erector spinae muscles (hazard ratio [95% confidence interval] = 3.21 [1.30–7.89]). Conclusion Low antigravity muscle density could reflect airway wall thickening and shorten healthy life expectancy in normal-weight patients with COPD.
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spelling doaj-art-62d5d8d96f0645ceb83f6a3dd543a8252025-08-20T02:17:56ZengBMCRespiratory Research1465-993X2025-04-0126111010.1186/s12931-025-03211-yAntigravity muscle density on computed tomography and health-related independence in normal weight patients with chronic obstructive pulmonary diseaseSatoru Terada0Naoya Tanabe1Tomoki Maetani2Yusuke Shiraishi3Kunihiko Terada4Hiroshi Shima5Tsuyoshi Oguma6Ryo Sakamoto7Megumi Kanasaki8Izuru Masuda9Atsuyasu Sato10Susumu Sato11Toyohiro Hirai12Department of Respiratory Medicine, Graduate School of Medicine, Kyoto UniversityDepartment of Respiratory Medicine, Graduate School of Medicine, Kyoto UniversityDepartment of Respiratory Medicine, Graduate School of Medicine, Kyoto UniversityDepartment of Respiratory Medicine, Graduate School of Medicine, Kyoto UniversityRespiratory Medicine and General Practice, Terada ClinicDepartment of Respiratory Medicine, Graduate School of Medicine, Kyoto UniversityDepartment of Respiratory Medicine, Graduate School of Medicine, Kyoto UniversityDepartment of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto UniversityMedical examination center, Takeda HospitalClinical Research Institute, National Hospital Organization, Kyoto Medical CenterDepartment of Respiratory Medicine, Graduate School of Medicine, Kyoto UniversityDepartment of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto UniversityDepartment of Respiratory Medicine, Graduate School of Medicine, Kyoto UniversityAbstract Background Low body mass index (BMI) is a prognostic factor, and skeletal muscle adiposity may affect mortality irrespective of BMI in patients with chronic obstructive pulmonary disease (COPD). However, the association between muscle adiposity and healthy life expectancy in normal-weight patients remains unestablished. Objective To examine whether lower chest computed tomography (CT)-assessed erector spinae muscle density (ESMD), which represents antigravity muscle adiposity, is associated with subsequent loss of health-related independence in normal-weight patients with COPD. Methods The ESMD lower limit of normal (LLN) was determined in 194 healthy subjects undergoing lung cancer screening CT. In a prospective cohort of patients with COPD undergoing baseline inspiratory/expiratory CT, the onset of loss of health-related independence, requiring long-term nursing facility or home nursing/medical care, was recorded over 5 years. Results Smokers with COPD (n = 199) were divided into 4 groups on the basis of BMI and the ESMD–LLN: underweight (n = 22), normal-weight with (n = 40) and without (n = 81) low ESMD, and overweight (n = 56). Greater airway wall thickening was associated with BMI-independent low ESMD. A multivariable Cox proportional hazards model including only normal-weight patients with COPD (n = 121) indicated that low ESMD was independently associated with a higher loss-of-independence rate after adjusting for FEV1, COPD assessment test score, and a smaller cross-sectional area of erector spinae muscles (hazard ratio [95% confidence interval] = 3.21 [1.30–7.89]). Conclusion Low antigravity muscle density could reflect airway wall thickening and shorten healthy life expectancy in normal-weight patients with COPD.https://doi.org/10.1186/s12931-025-03211-yChronic obstructive pulmonary diseaseComputed tomographyHealthy life expectancySkeletal muscleAirway wall thickness
spellingShingle Satoru Terada
Naoya Tanabe
Tomoki Maetani
Yusuke Shiraishi
Kunihiko Terada
Hiroshi Shima
Tsuyoshi Oguma
Ryo Sakamoto
Megumi Kanasaki
Izuru Masuda
Atsuyasu Sato
Susumu Sato
Toyohiro Hirai
Antigravity muscle density on computed tomography and health-related independence in normal weight patients with chronic obstructive pulmonary disease
Respiratory Research
Chronic obstructive pulmonary disease
Computed tomography
Healthy life expectancy
Skeletal muscle
Airway wall thickness
title Antigravity muscle density on computed tomography and health-related independence in normal weight patients with chronic obstructive pulmonary disease
title_full Antigravity muscle density on computed tomography and health-related independence in normal weight patients with chronic obstructive pulmonary disease
title_fullStr Antigravity muscle density on computed tomography and health-related independence in normal weight patients with chronic obstructive pulmonary disease
title_full_unstemmed Antigravity muscle density on computed tomography and health-related independence in normal weight patients with chronic obstructive pulmonary disease
title_short Antigravity muscle density on computed tomography and health-related independence in normal weight patients with chronic obstructive pulmonary disease
title_sort antigravity muscle density on computed tomography and health related independence in normal weight patients with chronic obstructive pulmonary disease
topic Chronic obstructive pulmonary disease
Computed tomography
Healthy life expectancy
Skeletal muscle
Airway wall thickness
url https://doi.org/10.1186/s12931-025-03211-y
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