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Fat mass to fat-free mass ratio and its associations with clinical characteristics in asthma

  • Diery Fernandes Rugila
    Affiliations
    Postgraduate Program in Rehabilitation Sciences, Pitágoras-Unopar University (UNOPAR), Londrina, Paraná, Brazil

    Department of Physical Therapy, Laboratory of Research in Respiratory Physiotherapy (LFIP), State University of Londrina (UEL), Londrina, Paraná, Brazil
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  • Joice Mara Oliveira
    Affiliations
    Postgraduate Program in Rehabilitation Sciences, Pitágoras-Unopar University (UNOPAR), Londrina, Paraná, Brazil

    Department of Physical Therapy, Laboratory of Research in Respiratory Physiotherapy (LFIP), State University of Londrina (UEL), Londrina, Paraná, Brazil
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  • Felipe Vilaça Cavallari Machado
    Affiliations
    Department of Physical Therapy, Laboratory of Research in Respiratory Physiotherapy (LFIP), State University of Londrina (UEL), Londrina, Paraná, Brazil

    Department of Research and Development, CIRO+, Horn, The Netherlands

    NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands

    Department of Respiratory Medicine, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
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  • Natielly Soares Correia
    Affiliations
    Postgraduate Program in Rehabilitation Sciences, Pitágoras-Unopar University (UNOPAR), Londrina, Paraná, Brazil

    Department of Physical Therapy, Laboratory of Research in Respiratory Physiotherapy (LFIP), State University of Londrina (UEL), Londrina, Paraná, Brazil
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  • Vitória Cavalheiro Puzzi
    Affiliations
    Postgraduate Program in Rehabilitation Sciences, Pitágoras-Unopar University (UNOPAR), Londrina, Paraná, Brazil

    Department of Physical Therapy, Laboratory of Research in Respiratory Physiotherapy (LFIP), State University of Londrina (UEL), Londrina, Paraná, Brazil
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  • Natália Febrini Piassi Passos
    Affiliations
    Department of Physical Therapy, School of Medicine, University of Sao Paulo (USP), Sao Paulo, Brazil
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  • Patrícia Duarte Freitas
    Affiliations
    Department of Physical Therapy, School of Medicine, University of Sao Paulo (USP), Sao Paulo, Brazil
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  • Fabio Pitta
    Affiliations
    Department of Physical Therapy, Laboratory of Research in Respiratory Physiotherapy (LFIP), State University of Londrina (UEL), Londrina, Paraná, Brazil
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  • Celso Ricardo Fernandes Carvalho
    Affiliations
    Department of Physical Therapy, School of Medicine, University of Sao Paulo (USP), Sao Paulo, Brazil
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  • Karina Couto Furlanetto
    Correspondence
    Corresponding author.
    Affiliations
    Postgraduate Program in Rehabilitation Sciences, Pitágoras-Unopar University (UNOPAR), Londrina, Paraná, Brazil

    Department of Physical Therapy, Laboratory of Research in Respiratory Physiotherapy (LFIP), State University of Londrina (UEL), Londrina, Paraná, Brazil
    Search for articles by this author

      Highlights

      • FM/FFM is associated with different clinical outcomes (factors) in adults with asthma.
      • Factors are corticosteroids, medication steps, lung function and physical activity.
      • Those with higher FM/FFM are more likely to be in stages 4–5 and physically inactive.

      Abstract

      Background

      Fat mass to fat-free mass ratio (FM/FFM) assesses the combined effect of the balance between fat mass and fat-free mass. Aims: to evaluate the associations beetween FM/FFM and clinical outcomes in asthma and to compare clinical characteristics between individuals with higher and lower FM/FFM.

      Methods

      128 participants with asthma underwent anthropometric, spirometry and bioelectrical impedance assessments. Physical activity in daily life (PADL) was assessed by the Actigraph for 7 days. Daily dose of inhaled medication, steps of pharmacological treatment, Asthma Control Questionnaire, Asthma Quality of Life Questionnaire and Hospital Anxiety and Depression Scale were also assessed. Participants were classified into two groups according to the 50th percentile of reference values for FM/FFM.

      Results

      Individuals with higher FM/FFM (n=75) used higher daily doses of inhaled corticosteroids, had worse lung function and fewer steps/day when compared to those with lower FM/FFM (n=53) (P≤0.021). Associations were found between absolute values of FM/FFM with lung function (FEV1 and FVC [liters]): R2=0.207 and 0.364;P<0.0001), and between the categories of lower or higher FM/FFM with steps of medication treatment (Cramer's V=0.218;P=0.016) and level of PADL (Cramer's V=0.236;P=0.009). The highest FM/FFM was a determining factor of physical inactivity (OR: 3.21;95%CI:1.17–8.78) and highest steps of pharmacological treatment (OR: 8.89;95%CI:1.23–64.08).

      Conclusion

      Higher FM/FFM is significantly associated with worse clinical characteristics in individuals with asthma, such as higher doses of inhaled corticosteroids, worse lung function and fewer steps/day. Moreover, higher FM/FFM is a determining factor of physical inactivity and the highest steps of pharmacological treatment for asthma.

      Keywords

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