Cause of mortality and sarcopenia in patients with idiopathic pulmonary fibrosis receiving <scp>antifibrotic</scp> therapy
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- Yuzo Suzuki
- Second Division, Department of Internal Medicine Hamamatsu University School of Medicine Hamamatsu Japan
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- Yuya Aono
- Second Division, Department of Internal Medicine Hamamatsu University School of Medicine Hamamatsu Japan
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- Masato Kono
- Department of Respiratory Medicine Seirei Hamamatsu General Hospital Hamamatsu Japan
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- Hirotsugu Hasegawa
- Department of Respiratory Medicine Seirei Mikatahara General Hospital Hamamatsu Japan
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- Koushi Yokomura
- Department of Respiratory Medicine Seirei Mikatahara General Hospital Hamamatsu Japan
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- Hyogo Naoi
- Second Division, Department of Internal Medicine Hamamatsu University School of Medicine Hamamatsu Japan
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- Hironao Hozumi
- Second Division, Department of Internal Medicine Hamamatsu University School of Medicine Hamamatsu Japan
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- Masato Karayama
- Second Division, Department of Internal Medicine Hamamatsu University School of Medicine Hamamatsu Japan
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- Kazuki Furuhashi
- Second Division, Department of Internal Medicine Hamamatsu University School of Medicine Hamamatsu Japan
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- Noriyuki Enomoto
- Second Division, Department of Internal Medicine Hamamatsu University School of Medicine Hamamatsu Japan
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- Tomoyuki Fujisawa
- Second Division, Department of Internal Medicine Hamamatsu University School of Medicine Hamamatsu Japan
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- Yutaro Nakamura
- Second Division, Department of Internal Medicine Hamamatsu University School of Medicine Hamamatsu Japan
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- Naoki Inui
- Second Division, Department of Internal Medicine Hamamatsu University School of Medicine Hamamatsu Japan
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- Hidenori Nakamura
- Department of Respiratory Medicine Seirei Hamamatsu General Hospital Hamamatsu Japan
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- Takafumi Suda
- Second Division, Department of Internal Medicine Hamamatsu University School of Medicine Hamamatsu Japan
抄録
<jats:title>ABSTRACT</jats:title><jats:sec><jats:title>Background and objective</jats:title><jats:p>Recent research has highlighted the fundamental role of sarcopenia, characterized by loss of skeletal muscle mass and strength, with a risk of poor outcomes. AFT preserves lung function by preventing the annual decline in FVC and is associated with improved outcomes in patients with IPF. However, altered cause of death and prognostic implications of sarcopenia in patients with IPF receiving AFT remain unknown.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This study comprised two cohorts of patients with IPF receiving AFT, historical cohort of IPF patients without AFT and controls. The cause of mortality was compared with a historical cohort. Sarcopenia was assessed by measuring the ESM<jats:sub>CSA</jats:sub> and ESM<jats:sub>MA</jats:sub> via CT.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Patients with IPF had smaller ESM<jats:sub>CSA</jats:sub> and lower ESM<jats:sub>MA</jats:sub> but similar BMI than controls, suggesting patients with IPF had skeletal muscle loss without any obvious body weight loss. The most common cause of mortality in patients receiving AFT was chronic respiratory failure, accounting for approximately 60%, and decreased proportions of LC were found. Subsequently, low ESM<jats:sub>CSA</jats:sub> was an independent prognostic factor associated with worse survival rates. Furthermore, combined assessment of ESM<jats:sub>CSA</jats:sub>, %FVC predicted and BMI values provided clear prognostic distinction.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Patients with IPF receiving AFT showed skeletal muscle loss without obvious weight loss. These patients mostly died by chronic respiratory failure, and skeletal muscle wasting has prognostic significance, suggesting that preventing sarcopenia as well as preserving lung function are important for managing these patients.</jats:p></jats:sec>
収録刊行物
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- Respirology
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Respirology 26 (2), 171-179, 2020-09-23
Wiley
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詳細情報 詳細情報について
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- CRID
- 1360290617842453376
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- ISSN
- 14401843
- 13237799
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- データソース種別
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- Crossref
- KAKEN