Avaliação da composição corporal e sua correlação com a função pulmonar em adultos com anemia falciforme

Abstract

Sickle cell anemia is a hereditary disease of high prevalence in Brazil and worldwide. Acute and chronic complications caused by the disease affect multiple organs and systems, including the lung, one of the main organs affected. The disease has also impact in nutritional status and body composition. It is assumed that people with sickle cell anemia may early develop sarcopenia. Progressive loss of muscle mass accompanied by decreased strength are characteristics observed in sarcopenia. This alteration in body composition could be related to impaired pulmonary function. The aim of this study was to investigate body composition, the presence of sarcopenia, and their relationship with lung function in adults with sickle cell anemia. A Cross-sectional study was performed with adults with sickle cell anemia treated at the hematology clinic of the Pedro Ernesto University Hospital. Skeletal muscle mass and other body composition parameters were evaluated by electrical bioimpedance. Muscle strength and functional capacity were assessed by grip strength and usual gait speed. Sarcopenia was diagnosed using the definition and cut-off points proposed by the European Working Group on Sarcopenia in Elderly People. The following pulmonary function tests were performed: spirometry, body plethysmography and measurement of respiratory muscle strength. The study included a total of 46 participants with a mean age of 29.5 ± 10.9 years. 21 (45.7%) had low fat free mass. Sarcopenia was diagnosed in 14 (30.4%) participants: 3 (6.5%) with pre-sarcopenia, 7 (15.2%) with sarcopenia and 4 (8.7%) with severe sarcopenia. Impaired lung function was present in 33 (71.7%) participants. Those with sarcopenia had significantly lower total lung capacity (p = 0.009), maximum inspiratory pressure (p = 0.018) and maximum expiratory pressure (p = 0.006). Skeletal muscle mass and fat free mass had high to moderate positive correlation with parameters of pulmonary function and respiratory muscle strength. Correlation between body fat and pulmonary function test parameters was observed only in women. Also, among women low body fat and fat free mass index were highly associated with increased risk of low total lung capacity and peak expiratory flow. In conclusion the results showed high prevalence of sarcopenia, as well as decreased fat-free mass in this sample of 46 adults with sickle cell anemia. Abnormalities in body composition were related to impairment of lung function, which was more evident among women.