Reduced Skeletal Muscle Mass Is Associated with an Increased Risk of Asthma Control and Exacerbation

Shuwen Zhang; Xin Zhang; Ke Deng; Changyong Wang; Lisa G Wood; Huajing Wan; Lei Liu; Ji Wang; Li Zhang; Ying Liu; Gaiping Cheng; Peter G Gibson; Brian G Oliver; Fengming Luo; Vanessa M McDonald; Weimin Li; Gang Wang

doi:10.3390/jcm11237241

Reduced Skeletal Muscle Mass Is Associated with an Increased Risk of Asthma Control and Exacerbation

J Clin Med. 2022 Dec 6;11(23):7241. doi: 10.3390/jcm11237241.

Authors

Shuwen Zhang^{1

2

3}, Xin Zhang^{1

2

3}, Ke Deng^{2

3}, Changyong Wang^{2

3}, Lisa G Wood⁴, Huajing Wan^{2

3}, Lei Liu^{1

2

3}, Ji Wang^{2

3}, Li Zhang^{1

2

3}, Ying Liu^{1

2

3}, Gaiping Cheng⁵, Peter G Gibson⁶, Brian G Oliver^{7

8}, Fengming Luo^{2

3}, Vanessa M McDonald⁶, Weimin Li^{2

9}, Gang Wang^{2

3}

Affiliations

¹ Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China.
² Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu 610041, China.
³ Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu 610041, China.
⁴ Priority Research Center for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, New Lambton, NSW 2308, Australia.
⁵ Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu 610041, China.
⁶ Centre of Excellence in Severe Asthma and Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, Newcastle, NSW 2300, Australia.
⁷ School of Life Sciences, University of Technology Sydney, Ultimo, NSW 2007, Australia.
⁸ Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW 2000, Australia.
⁹ Respiratory Microbiome Laboratory, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu 610041, China.

Abstract

Background: Skeletal muscle mass (SMM) has been suggested to be associated with multiple health-related outcomes. However, the potential influence of SMM on asthma has not been largely explored.

Objective: To study the association between SMM and clinical features of asthma, including asthma control and exacerbation, and to construct a model based on SMM to predict the risk of asthma exacerbation (AEx).

Methods: In this prospective cohort study, we consecutively recruited patients with asthma (n = 334), classified as the SMM ^Normal group (n = 223), SMM ^Low group (n = 88), and SMM ^High group (n = 23). We investigated the association between SMM and clinical asthma characteristics and explored the association between SMM and asthma control and AEx within a 12-month follow-up period. Based on SMM, an exacerbation prediction model was developed, and the overall performance was externally validated in an independent cohort (n = 157).

Results: Compared with the SMM ^Normal group, SMM ^Low group exhibited more airway obstruction and worse asthma control, while SMM ^High group had a reduced eosinophil percentage in induced sputum. Furthermore, SMM ^Low group was at a significantly increased risk of moderate-to-severe exacerbation compared with the SMM ^Normal group (relative risk _adjusted 2.02 [95% confidence interval (CI), 1.35-2.68]; p = 0.002). In addition, a model involving SMM was developed which predicted AEx (area under the curve: 0.750, 95% CI: 0.691-0.810).

Conclusions: Low SMM was an independent risk factor for future AEx. Furthermore, a model involving SMM for predicting the risk of AEx in patients with asthma indicated that assessment of SMM has potential clinical implications for asthma management.

Keywords: asthma; clinical prediction model; exacerbation; skeletal muscle mass.

Abstract

Grants and funding