Sarcopenia is associated with mild-to-moderate Bronchiectasis: Hints from functional, histological, and imaging assessment

<bold>Introduction:</bold> Non-cystic fibrosis (CF) bronchiectasis is a heterogeneous, multidimensional airway disease with systemic involvement, such as sarcopenia, which has been little studied in these patients to date. Our objective is to demonstrate the presence of sarcopenia in patients with stable BQ. <bold>Material and methods:</bold> Twenty stable BQ patients with sarcopenia and 10 healthy control subjects were recruited. All patients and controls were assessed clinically (FACED, EFACED, BSI) and muscle (function and imaging by MRI and US). In addition, muscle phenotype (morphometry, apoptosis and muscle damage) was analysed by immunohistochemistry from VL biopsies. <bold>Results:</bold> In patients (mild-moderate respiratory disease), compared to controls, nutritional and muscle functional status (sarcopenia) was decreased, while systemic inflammation was increased. In patients, VL thickness and area were lower, while in muscle fibres, levels of fatty infiltration, damage, number of apoptotic nuclei and hybrid fibres were higher. Significant positive correlations were found between disease severity scores and age, fatty infiltration and inflammatory parameters, whereas disease severity scores correlated with age, fatty infiltration and inflammatory parameters correlated negatively with muscle strength, exercise capacity and VL area. <bold>Conclusions:</bold> In patients with mild to moderate BQ, the presence of sarcopenia was confirmed by functional, imaging and structural approaches by alteration of VL architecture together with regenerative events. Disease severity scores suggest that the impact of sarcopenia is greater in patients with more advanced disease, even in stable conditions.