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- Johansson Strandkvist, Viktor, et al.
(author)
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Hand grip strength is associated with forced expiratory volume in 1 second among subjects with COPD : report from a population-based cohort study
- 2016
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In: The International Journal of Chronic Obstructive Pulmonary Disease. - : Dove Medical Press. - 1176-9106 .- 1178-2005. ; 11, s. 2527-2534
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Journal article (peer-reviewed)abstract
- Background: Cardiovascular diseases and skeletal muscle dysfunction are common comorbidities in COPD. Hand grip strength (HGS) is related to general muscle strength and is associated with cardiovascular disease and all-cause mortality, while the results from small selected COPD populations are contradictory. The aim of this population-based study was to compare HGS among the subjects with and without COPD, to evaluate HGS in relation to COPD severity, and to evaluate the impact of heart disease. Subjects and methods: Data were collected from the Obstructive Lung disease in Northern Sweden COPD study, where the subjects with and without COPD have been invited to annual examinations since 2005. In 2009-2010, 441 subjects with COPD (postbronchodilator forced expiratory volume in 1 second [FEV1]/vital capacity,0.70) and 570 without COPD participated in structured interviews, spirometry, and measurements of HGS. Results: The mean HGS was similar when comparing subjects with and without COPD, but those with heart disease had lower HGS than those without. When compared by Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades, the subjects with GOLD 3-4 had lower HGS than those without COPD in both sexes (females 21.4 kg vs 26.9 kg, P=0.010; males 41.5 kg vs 46.3 kg, P=0.038), and the difference persisted also when adjusted for confounders. Among the subjects with COPD, HGS was associated with FEV1% of predicted value but not heart disease when adjusted for height, age, sex, and smoking habits, and the pattern was similar among males and females. Conclusion: In this population-based study, the subjects with GOLD 3-4 had lower HGS than the subjects without COPD. Among those with COPD, HGS was associated with FEV1% of predicted value but not heart disease, and the pattern was similar in both sexes.
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- Johansson Strandkvist, Viktor, et al.
(author)
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Impact of heart disease on hand grip strength in COPD: epidemiological data
- 2016
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Conference paper (peer-reviewed)abstract
- Background: Hand grip strength (HGS) and heart disease (HD) are related to mortality. Peripheral muscle dysfunction and HD are both frequently observed among subjects with COPD, but the relationship between HGS and HD in COPD is unclear.Aim: To evaluate HGS and the impact of HD among subjects with and without COPD.Methods: Data was collected from the OLIN (Obstructive Lung Disease in Northern Sweden) COPD study, where subjects with COPD have been invited to annual examinations since 2005 together with age- and sex-matched subjects without COPD. During 2009, 441 subjects with COPD and 570 without COPD participated in examinations including structured interviews, spirometry and measurements of HGS. COPD was defined as post-bronchodilator FEV1/VC<0.70.Results: Both among subjects with and without COPD, and in both sexes, those with HD had significantly lower HGS. The proportion of subjects below estimated normal value for HGS was similar in subjects with and without COPD and in both sexes; among women (35.4 vs. 33.4%, p=0.714) and men (19.1 vs 15.9%, p=0.315). In a linear regression model among subjects with COPD only, HGS was significantly associated with age, beta coefficient (B) = -0.46 (p<0.001), sex, B=19.85 (p<0.001) and FEV1 % of predicted normal value, B=0.06 (p=0.007), but not with HD or smoking habits. When a similar model was estimated among subjects without COPD, HGS was only associated with age and sex.Conclusions: In this population-based study, subjects with heart disease had lower hand grip strength regardless if they had COPD or not. Among COPD subjects, hand grip strength was associated with age, sex and FEV1, but not with heart disease.
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- Lindberg, Anne, et al.
(author)
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From COPD epidemiology to studies of pathophysiological disease mechanisms : challenges with regard to study design and recruitment process
- 2017
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In: European Clinical Respiratory Journal. - : Taylor & Francis. - 2001-8525. ; 4
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Journal article (peer-reviewed)abstract
- Background: Chronic obstructive pulmonary disease (COPD) is a largely underdiagnosed disease including several phenotypes. In this report, the design of a study intending to evaluate the pathophysiological mechanism in COPD in relation to the specific phenotypes non-rapid and rapid decline in lung function is described together with the recruitment process of the study population derived from a population based study.Method: The OLIN COPD study includes a population-based COPD cohort and referents without COPD identified in 2002–04 (n = 1986), and thereafter followed annually since 2005. Lung function decline was estimated from baseline in 2002–2004 to 2010 (first recruitment phase) or to 2012/2013 (second recruitment phase). Individuals who met the predefined criteria for the following four groups were identified; group A) COPD grade 2–3 with rapid decline in FEV1 and group B) COPD grade 2–3 without rapid decline in FEV1 (≥60 and ≤30 ml/year, respectively), group C) ever-smokers, and group D) non-smokers with normal lung function. Groups A–C included ever-smokers with >10 pack years. The intention was to recruit 15 subjects in each of the groups A-D.Results: From the database groups A–D were identified; group A n = 37, group B n = 29, group C n = 41, and group D n = 55. Fifteen subjects were recruited from groups C and D, while this goal was not reached in the groups A (n = 12) and B (n = 10). The most common reasons for excluding individuals identified as A or B were comorbidities contraindicating bronchoscopy, or inflammatory diseases/immune suppressive medication expected to affect the outcome.Conclusion: The study is expected to generate important results regarding pathophysiological mechanisms associated with rate of decline in lung function among subjects with COPD and the in-detail described recruitment process, including reasons for non-participation, is a strength when interpreting the results in forthcoming studies.
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- Stridsman, Caroline, et al.
(author)
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The COPD Assessment Test (CAT) can screen for fatigue among patients with COPD
- 2018
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In: Therapeutic Advances in Respiratory Disease. - : Sage Publications. - 1753-4658 .- 1753-4666. ; 12
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Journal article (peer-reviewed)abstract
- Background:Fatigue is one of the most common symptoms among subjects with chronic obstructive pulmonary disease (COPD), but is rarely identified in clinical practice. The aim of this study was to evaluate the association between fatigue and health-related quality of life (HRQoL) assessed with clinically useful instruments, both among subjects with and without COPD. Further, to investigate the association between fatigue and the COPD Assessment Test (CAT)-energy question.Methods:Data were collected in 2014 within the population-based OLIN COPD study. Subjects with (n = 367) and without (n = 428) COPD participated in clinical examinations including spirometry and completed questionnaires about fatigue (FACIT-Fatigue, clinically relevant fatigue ⩽43), and HRQoL (EQ-5D-VAS, lower score = worse health; CAT, lower score = fewer symptoms/better health).Results:Subjects with clinically relevant fatigue had worse HRQoL measured with EQ-5D-VAS, regardless of having COPD or not. Decreasing EQ-5D-VAS scores, any respiratory symptoms and anxiety/depression were associated with clinically relevant fatigue also when adjusted for confounders. Among subjects with COPD, clinically relevant fatigue was associated with increasing total CAT score, and CAT score ⩾10. The proportion of subjects with clinically relevant fatigue increased significantly, with a higher score on the CAT-energy question, and nearly 50% of those with a score of 2, and 70% of those with a score of ⩾3, had clinically relevant fatigue.Conclusions:Fatigue was associated with respiratory symptoms, anxiety/depression and worse HRQoL when using the clinically useful instruments EQ-5D-VAS and CAT. The CAT-energy question can be used to screen for fatigue in clinical practice, using a cut-off of ⩾2.
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