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Whole-body resting and exercise-induced lipolysis in sarcopaenic patients with COPD

¹ Dept of Respiratory Medicine, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Hospital, Maastricht, and ² Dept of Endocrinology and Metabolism, Academic Medical Center, Amsterdam, the Netherlands.

CORRESPONDENCE: F. M. E. Franssen, Dept of Respiratory Medicine, University Hospital Maastricht, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Fax: 31 433875051. E-mail: f.franssen{at}pul.unimaas.nl

Keywords: Body composition, chronic obstructive pulmonary disease, exercise, fat mass, intermediary metabolism, lipolysis

Received: January 29, 2008
Accepted June 12, 2008

Impaired β-adrenoceptor-mediated lipolysis has been reported in sarcopaenic chronic obstructive pulmonary disease (COPD) patients. This could play a role in the shift in body composition towards decreased fat-free mass (FFM) and relative maintenance of fat mass (FM). Lipolysis could be affected by chronic treatment with β₂-agonists or disease-related factors. Therefore, whole-body resting and exercise-induced lipolysis were investigated in sarcopaenic COPD patients with moderate disease severity.

Seven sarcopaenic COPD patients (mean±SEM forced expiratory volume in one second (FEV₁) 53±5% of the predicted value; body mass index (BMI) 27.5±0.9 kg·m^–2) and seven controls matched for age, sex and BMI were studied. In addition, six underweight COPD patients (FEV₁ 51±5% pred; BMI 20.6±0.7 kg·m^–2) matched for disease severity were recruited. Lipolysis and plasma levels of catecholamines were assessed during infusion of [²H₅]glycerol at rest and during submaximal cycling exercise.

The proportional FM was comparable between sarcopaenic patients and controls, whereas the FFM index was significantly reduced in patients. At rest, the rate of appearance (R_a) of glycerol (4.1±0.6 and 3.3±0.2 µmol·kg FFM^–1·min^–1, respectively) did not differ significantly. In underweight patients, glycerol R_a (4.3±0.5 µmol·kg FFM^–1·min^–1) was also comparable. End-of-exercise lipolytic rates did not differ significantly between groups. Glycerol R_a was not related to FM. Resting adrenalin levels were significantly increased in underweight COPD patients and were related to resting lipolysis.

Sarcopaenia in chronic obstructive pulmonary disease patients with moderate disease severity is not characterised by an abnormal lipolytic rate. Altered regulation of muscle protein turnover seems to be the trigger in the body compositional shift observed in these patients.

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