PT  - JOURNAL ARTICLE
AU  - Elizabeth Benz
AU  - Sara R.A. Wijnant
AU  - Katerina Trajanoska
AU  - Johnmary T. Arinze
AU  - Emmely W. de Roos
AU  - Maria de Ridder
AU  - Ross Williams
AU  - Frank van Rooij
AU  - Katia M.C. Verhamme
AU  - M. Arfan Ikram
AU  - Bruno H. Stricker
AU  - Fernando Rivadeneira
AU  - Lies Lahousse
AU  - Guy G. Brusselle
TI  - Sarcopenia, systemic immune-inflammation index and all-cause mortality in middle-aged and older people with COPD and asthma: a population-based study
AID  - 10.1183/23120541.00628-2021
DP  - 2022 Jan 01
TA  - ERJ Open Research
PG  - 00628-2021
VI  - 8
IP  - 1
4099  - http://openres.ersjournals.com/content/8/1/00628-2021.short
4100  - http://openres.ersjournals.com/content/8/1/00628-2021.full
SO  - erjor2022 Jan 01; 8
AB  - Background Increasing evidence suggests that sarcopenia and a higher systemic immune-inflammation index (SII) are linked with morbidity in patients with COPD. However, whether these two conditions contribute to all-cause mortality in middle-aged and older patients with COPD or asthma is unclear. Therefore, we investigated the association between sarcopenia, SII, COPD or asthma and all-cause mortality in a large-scale population-based setting.Methods Between 2009 and 2014, 4482 participants (aged >55 years; 57.3% female) from the population-based Rotterdam Study were included. COPD and asthma patients were diagnosed clinically and based on spirometry. Six study groups were defined according to the presence or absence of COPD or asthma and sarcopenia. Cox regression models were used to assess all-cause mortality in the study groups, adjusted for sex, age, body mass index, SII, smoking, oral corticosteroid use and comorbidities. In addition, all participants were categorised into sex-specific quartiles of SII, and mortality in these groups was compared.Results Over a median follow-up of 6.1 years (interquartile range 5.0–7.2 years), 466 (10.4%) persons died. Independent of the presence of sarcopenia, participants with COPD had a higher risk of all-cause mortality (hazard ratio (HR) 2.13, 95% CI 1.46–3.12 and HR 1.70, 95% CI 1.32–2.18 for those with and without sarcopenia, respectively). Compared to lower SII levels, higher SII levels increased mortality risk even in people without sarcopenia, COPD or asthma.Conclusion Middle-aged and older people with COPD, higher SII levels or sarcopenia had an independently increased mortality risk. Our study suggests prognostic usefulness of routinely evaluating sarcopenia and SII in older people with COPD or asthma.Sarcopenia and COPD increased the risk of all-cause mortality in middle-aged and older populations. Additionally, compared to lower SII levels, higher SII levels increased mortality risk in people with and without sarcopenia and COPD. https://bit.ly/3d659m2