Relationship between body composition, exercise capacity and health related quality of life in Idiopathic Pulmonary Fibrosis

© Author(s) (or their employer(s)) 2021. Reuse permitted under CC BYNC. No commercial reuse. See rights and permissions. Published by BMJ. ABSTRACT Introduction Bioelectrical impedance analysis (BIA) can be used to estimate FatFree Mass Index (FFMI). However, the use of directly measured BIA variables, such as phase angle (PhA), has gained attention. The frequency of low FFMI and PhA and its associations with exercise capacity and healthrelated quality of life (HRQL) in patients with idiopathic pulmonary fibrosis (IPF) have been scarcely studied. Objectives To investigate the frequency of low FFMI and PhA and their associations with exercise capacity and HRQL in patients with IPF. Methods Patients underwent assessment of lung function, body composition, exercise capacity by the 6 min walk distance (6MWD), and HRQL by the Medical Outcomes Study ShortForm 36item Questionnaire (SF36). Patients were classified as presenting normal or low PhA or FFMI, accordingly to the 10th percentiles of agesexbody mass index (BMI)specific reference values. Results 98 patients (84 males, age: 68±8 years, forced vital capacity: 64%±18%predicted) were included. 24 patients presented low PhA. They were characterised by worse lung function, exercise capacity and HRQL compared with patients with normal PhA. 10 patients presented low FFMI, but despite differences in body composition, no differences were found between these patients and patients with normal FFMI. In a single regression analysis, age, lung function and body composition variables (except FFMI) were related to 6MWD and SF36 Physical Summary Score (R2=0.06–0.36, p<0.05). None of the variables were related to SF36 Mental Summary Score. Conclusion Onefourth of the patients with IPF with normal to obese BMI present abnormally low PhA. Patients classified as low PhA presented worse lung function, exercise capacity and HRQL.