Fat-free mass index predicts survival in patients with idiopathic pulmonary fibrosis

Respirology. 2017 Apr;22(3):480-485. doi: 10.1111/resp.12941. Epub 2016 Nov 21.

Abstract

Background and objective: Detailed body composition, such as fat-free mass, has not been examined in idiopathic pulmonary fibrosis (IPF). We investigated whether the fat-free mass index (FFMI), an index of lean body mass, predicted survival.

Methods: Forty-four patients with IPF were enrolled in the study. Their body composition was assessed using direct segmental multi-frequency bioelectrical impedance analysis. The degree of correlation between variables of body composition and other variables such as forced vital capacity (FVC) and survival was examined.

Results: There was a significant positive correlation between FFMI and FVC, diffusion capacity of the lung for carbon monoxide (DLCO ) and 6-min walk distance, and a significant negative correlation with age. However, there was no significant correlation between FFMI and percentage predicted FVC or DLCO , with the degree of correlation being similar to that observed for BMI. The mean observation period in the survival analysis was 837.5 ± 407.5 days. A univariate Cox proportional hazard model showed that several variables, but not BMI, were associated significantly with survival. FFMI (hazard ratio (HR): 0.64, 95% CI: 0.43-0.94, P = 0.02) and percentage predicted FVC (HR: 0.96, 95% CI: 0.93-0.99, P=0.008) were significant factors in a multivariate model.

Conclusion: We conclude that FFMI is a significant independent predictor of survival in patients with IPF.

Keywords: body composition; fat-free mass; idiopathic pulmonary fibrosis; survival.

MeSH terms

  • Aged
  • Body Composition*
  • Body Mass Index
  • Carbon Monoxide
  • Electric Impedance
  • Female
  • Humans
  • Idiopathic Pulmonary Fibrosis / physiopathology*
  • Lung
  • Male
  • Prognosis
  • Proportional Hazards Models
  • Pulmonary Diffusing Capacity
  • Survival Rate
  • Vital Capacity
  • Walk Test

Substances

  • Carbon Monoxide