Physical activity and inactivity among different body composition phenotypes in individuals with moderate to very severe chronic obstructive pulmonary disease

Abstract Background The phenotype profiling of individuals with chronic obstructive pulmonary disease (COPD) according to impairments in body composition and level of physical activity in daily life (PADL) needs to be determined. Objective To verify if individuals with COPD classified as physically active/inactive present different characteristics within different body composition phenotypes. Methods Individuals with COPD were cross-sectionally stratified into four groups according to fat-free and fat mass indexes: Normal Body Composition (NBC), Obese (Ob), Sarcopenic (Sarc), and Sarcopenic/Obese (Sarc/Ob). Additionally, individuals had their PADL level objectively assessed through activity monitoring during two weekdays for at least 10 h/day, and then were classified as physically active (Act) or inactive (Inact) according to international recommendations. Lung function (spirometry), exercise capacity (6-minute walking test [6MWT]) and peripheral muscle strength (1-repetition maximum [1RM]) were also assessed. Results 176 individuals with COPD (mean ± standard deviation age: 67 ± 8 years, body mass index 26 ± 6 kg/m2, FEV1 47 ± 16%predicted) were classified as: NBC + Act (17%), NBC + Inact (22%), Ob + Act (6%), Ob + Inact (10%), Sarc + Act (12%), Sarc + Inact (9%), Sarc/Ob + Act (8%) and Sarc/Ob + Inact (16%). The Sarc/Ob + Inact group presented lower 6MWT and 1RM for knee extension compared to NBC + Act, NBC + Inact, and Ob + Act groups (p  Conclusion The combination of sarcopenia, obesity, and physical inactivity was shown to be detrimental in individuals with COPD. Therefore, this profile is a main therapeutic target for improving PADL level and/or body composition.