Ultrasound Assessment of the Rectus Femoris in Patients with Chronic Obstructive Pulmonary Disease Predicts Sarcopenia

Abstract

Purpose: Sarcopenia, an age-related loss of skeletal muscle mass and function, is frequent in patients with chronic obstructive pulmonary disease (COPD) and is linked to a poor prognosis. The diagnosis of sarcopenia requires specific equipment and is inconvenient to introduce into clinical practice. Ultrasound is an innovative method to assess muscle quantity. The objective of this research was to evaluate the use of ultrasound for prospectively screening for sarcopenia in COPD patients. Patients and Methods: A total of 235 stable patients with COPD were included in this observational study and divided into development and validation sets. The Asian Working Group for Sarcopenia standards were used to define sarcopenia. The thickness (RFthick) and cross-sectional area (RFcsa) of the rectus femoris were measured using ultrasound. Receiver operating characteristic curve analysis of RFthick and RFcsa was used to predict sarcopenia. Nomogram models were constructed based on RFthick, RFcsa, age and body mass index to identify sarcopenia. Results: Sarcopenia was present in 83 (35.32%) patients. Patients with sarcopenia had advanced age, decreased pulmonary function, decreased physical function and poor clinical outcomes. RFthick and RFcsa showed good predictive ability for sarcopenia in the development and validation sets. The nomogram based on RFthick and RFcsa could detect sarcopenia in COPD patients, and all had significant predictive performance in the development and validation sets. The calibration plot showed good agreement between the nomogram predictions and actual observations. Conclusion: The ultrasound measurement of the rectus femoris has potential for the clinical assessment of sarcopenia in patients with COPD.