Table 1

Systemic effects of chronic obstructive pulmonary disease

Systemic inflammation
 Oxidative stress
 Activated inflammatory cells (neutrophils/lymphocytes)
 Increased plasma levels of cytokines and acute phase proteins
Nutritional abnormalities and weight loss
 Increased resting energy expenditure
 Abnormal body composition
 Abnormal amino acid metabolism
Skeletal muscle dysfunction
 Loss of muscle mass
 Abnormal structure/function
 Exercise limitation
Other potential systemic effects
 Cardiovascular effects
 Nervous system effects
 Osteoskeletal effects