Body composition, maximal fitness, and submaximal exercise function in people with interstitial lung disease
Abstract Background Cardiopulmonary exercise testing (CPET) is feasible, valid, reliable, and clinically useful in interstitial lung disease (ILD). However, maximal CPET values are often presented relative to body mass, whereas fat-free mass (FFM) may better reflect metabolically active muscle durin...
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| Language: | English |
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BMC
2025-04-01
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| Series: | Respiratory Research |
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| Online Access: | https://doi.org/10.1186/s12931-025-03195-9 |
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| author | Owen W. Tomlinson Anna Duckworth Laura Markham Rebecca L. Wollerton Michael Gibbons Chris J. Scotton Craig A. Williams |
| author_facet | Owen W. Tomlinson Anna Duckworth Laura Markham Rebecca L. Wollerton Michael Gibbons Chris J. Scotton Craig A. Williams |
| author_sort | Owen W. Tomlinson |
| collection | DOAJ |
| description | Abstract Background Cardiopulmonary exercise testing (CPET) is feasible, valid, reliable, and clinically useful in interstitial lung disease (ILD). However, maximal CPET values are often presented relative to body mass, whereas fat-free mass (FFM) may better reflect metabolically active muscle during exercise. Moreover, despite the value of maximal parameters, people with ILD do not always exercise maximally and therefore clinically relevant submaximal parameters must be identified. Therefore, this study assessed peak oxygen uptake (VO2peak) relative to FFM, identifying the validity of common scaling techniques; as well as characterising the oxygen uptake efficiency slope (OUES) and plateau (OUEP) as possible submaximal parameters. Methods Participants with ILD underwent assessment of body composition and CPET via cycle ergometry during a single study visit. To determined effectiveness of scaling for body size, both body mass and FFM were scaled using ratio-standard (X/Y) and allometric (X/Yb) techniques. Pearsons’s correlations determined agreement between OUES, OUEP, and parameters of lung function. Cohens kappa (κ) assessed agreement between OUES, OUEP and VO2peak. Results A total of 24 participants (7 female; 69.8 ± 7.5 years; 17 with idiopathic pulmonary fibrosis) with ILD completed the study. Maximal exercise parameters did not require allometric scaling, and when scaled to FFM, it was shown that women have a significantly higher VO2peak than men (p = 0.044). Results also indicated that OUEP was significantly and positively correlated with DLCO (r = 0.719, p < 0.001), and held moderate agreement with VO2peak (κ = 0.50, p < 0.01). Conclusion This study identified that ratio-standard scaling is sufficient in removing residual effects of body size from VO2peak, and that VO2peak is higher in women when FFM is considered. Encouragingly, this study also identified OUEP as a possible alternative submaximal marker in people with ILD, and thus warrants further examination. |
| format | Article |
| id | doaj-art-274ba1d16f184988891df519a1b0bc12 |
| institution | Kabale University |
| issn | 1465-993X |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Respiratory Research |
| spelling | doaj-art-274ba1d16f184988891df519a1b0bc122025-08-20T03:45:34ZengBMCRespiratory Research1465-993X2025-04-0126111010.1186/s12931-025-03195-9Body composition, maximal fitness, and submaximal exercise function in people with interstitial lung diseaseOwen W. Tomlinson0Anna Duckworth1Laura Markham2Rebecca L. Wollerton3Michael Gibbons4Chris J. Scotton5Craig A. Williams6Department of Public Health and Sport Science, Faculty of Health and Life Science, University of ExeterAcademic Department of Respiratory Medicine, Royal Devon University Hospitals NHS Foundation TrustAcademic Department of Respiratory Medicine, Royal Devon University Hospitals NHS Foundation TrustAcademic Department of Respiratory Medicine, Royal Devon University Hospitals NHS Foundation TrustAcademic Department of Respiratory Medicine, Royal Devon University Hospitals NHS Foundation TrustAcademic Department of Respiratory Medicine, Royal Devon University Hospitals NHS Foundation TrustDepartment of Public Health and Sport Science, Faculty of Health and Life Science, University of ExeterAbstract Background Cardiopulmonary exercise testing (CPET) is feasible, valid, reliable, and clinically useful in interstitial lung disease (ILD). However, maximal CPET values are often presented relative to body mass, whereas fat-free mass (FFM) may better reflect metabolically active muscle during exercise. Moreover, despite the value of maximal parameters, people with ILD do not always exercise maximally and therefore clinically relevant submaximal parameters must be identified. Therefore, this study assessed peak oxygen uptake (VO2peak) relative to FFM, identifying the validity of common scaling techniques; as well as characterising the oxygen uptake efficiency slope (OUES) and plateau (OUEP) as possible submaximal parameters. Methods Participants with ILD underwent assessment of body composition and CPET via cycle ergometry during a single study visit. To determined effectiveness of scaling for body size, both body mass and FFM were scaled using ratio-standard (X/Y) and allometric (X/Yb) techniques. Pearsons’s correlations determined agreement between OUES, OUEP, and parameters of lung function. Cohens kappa (κ) assessed agreement between OUES, OUEP and VO2peak. Results A total of 24 participants (7 female; 69.8 ± 7.5 years; 17 with idiopathic pulmonary fibrosis) with ILD completed the study. Maximal exercise parameters did not require allometric scaling, and when scaled to FFM, it was shown that women have a significantly higher VO2peak than men (p = 0.044). Results also indicated that OUEP was significantly and positively correlated with DLCO (r = 0.719, p < 0.001), and held moderate agreement with VO2peak (κ = 0.50, p < 0.01). Conclusion This study identified that ratio-standard scaling is sufficient in removing residual effects of body size from VO2peak, and that VO2peak is higher in women when FFM is considered. Encouragingly, this study also identified OUEP as a possible alternative submaximal marker in people with ILD, and thus warrants further examination.https://doi.org/10.1186/s12931-025-03195-9Cardiopulmonary fitnessPulmonary diseaseExercise testing |
| spellingShingle | Owen W. Tomlinson Anna Duckworth Laura Markham Rebecca L. Wollerton Michael Gibbons Chris J. Scotton Craig A. Williams Body composition, maximal fitness, and submaximal exercise function in people with interstitial lung disease Respiratory Research Cardiopulmonary fitness Pulmonary disease Exercise testing |
| title | Body composition, maximal fitness, and submaximal exercise function in people with interstitial lung disease |
| title_full | Body composition, maximal fitness, and submaximal exercise function in people with interstitial lung disease |
| title_fullStr | Body composition, maximal fitness, and submaximal exercise function in people with interstitial lung disease |
| title_full_unstemmed | Body composition, maximal fitness, and submaximal exercise function in people with interstitial lung disease |
| title_short | Body composition, maximal fitness, and submaximal exercise function in people with interstitial lung disease |
| title_sort | body composition maximal fitness and submaximal exercise function in people with interstitial lung disease |
| topic | Cardiopulmonary fitness Pulmonary disease Exercise testing |
| url | https://doi.org/10.1186/s12931-025-03195-9 |
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