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Skeletal muscle dysfunction in chronic obstructive pulmonary disease

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Abstract

It has become increasingly recognized that skeletal muscle dysfunction is common in patients with chronic obstructive pulmonary disease (COPD). Muscle strength and endurance are decreased, whereas muscle fatigability is increased. There is a reduced proportion of type I fibers and an increase in type II fibers. Muscle atrophy occurs with a reduction in fiber cross-sectional area. Oxidative enzyme activity is decreased, and measurement of muscle bioenergetics during exercise reveals a reduced aerobic capacity. Deconditioning is probably very important mechanistically. Other mechanisms that may be of varying importance in individual patients include chronic hypercapnia and/or hypoxia, nutritional depletion, steroid usage, and oxidative stress. Potential therapies include exercise training, oxygen supplementation, nutritional repletion, and administration of anabolic hormones.

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Abbreviations

COPD:

chronic obstructive pulmonary disease

FEV1:

forced expiratory volume in 1 s

MRS:

magnetic resonance spectroscopy

Pi:

inorganic phosphate

VO2:

oxygen consumption.

References

  1. Bernard S, LeBlanc P, Whittom F, Carrier G, Jobin J, Belleau R, Maltais F: Peripheral muscle weakness in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1998, 158: 629-634.

    Article  PubMed  Google Scholar 

  2. Hamilton AL, Killian KJ, Summers E, Jones NL: Muscle strength, symptom intensity, and exercise capacity in patients with car-diorespiratory disorders. Am J Respir Crit Care Med. 1995, 152: 2021-2031.

    Article  PubMed  Google Scholar 

  3. Gosselink R, Troosters T, DeCramer M: Peripheral muscle weakness contributes to exercise limitation in COPD. Am J Respir Crit Care Med. 1996, 153: 976-980.

    Article  PubMed  Google Scholar 

  4. Serres I, Gautier V, Varray A, Prefaut C: Impaired skeletal muscle endurance related to physical inactivity and altered lung function in COPD patients. Chest. 1998, 113: 900-905.

    Article  PubMed  Google Scholar 

  5. Zattara-Hartmann MC, Badier M, Guillot C, Tomei C, Jammes Y: Maximal force and endurance to fatigue of respiratory and skeletal muscles in chronic hypoxemic patients: the effects of oxygen breathing. Muscle Nerve. 1995, 18: 495-502.

    Article  PubMed  Google Scholar 

  6. Newell SZ, McKenzie DK, Gandevia SC: Inspiratory and skeletal muscle strength and endurance and diaphragmatic activation in patients with chronic airflow limitation. Thorax. 1989, 44: 903-912.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Mador MJ, Kufel TJ, Pineda L: Quadriceps fatigue after cycle exercise in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2000, 161: 447-453.

    Article  Google Scholar 

  8. Kufel TJ, Pineda LA, Mador MJ: Comparison of potentiated and unpotentiated twitches as an index of contractile fatigue [abstract]. Am J Respir Crit Care Med. 1998, 157: A215-

    Google Scholar 

  9. Mador MJ, Kufel TJ, Pineda LA, Steinwald A, Aggarwal A, Upadhyay AM, Khan MA: Effect of pulmonary rehabilitation on quadriceps fatigability during exercise. Am J Respir Crit Care Med. 2001, 163: 930-935.

    Article  PubMed  Google Scholar 

  10. Mador MJ, Kufel TJ, Pineda LA: Quadriceps and diaphragmatic function after exhaustive cycle exercise in the healthy elderly. Am J Respir Crit Care Med. 2000, 162: 1760-1766.

    Article  Google Scholar 

  11. Whittom F, Jobin J, Simard PM, LeBlanc P, Simard C, Bernard S, Belleau R, Maltais F: Histochemical and morphological characteristics of the vastus lateralis muscle in patients with chronic obstructive pulmonary disease. Med Sci Sports Exerc. 1998, 30: 1467-1474. 10.1097/00005768-199810000-00001.

    Article  PubMed  Google Scholar 

  12. Maltais F, Sullivan MJ, LeBlanc P, Duscha BD, Schachat FH, Simard C, Blank JM, Jobin J: Altered expression of myosin heavy chain in the vastus lateralis muscle in patients with COPD. Eur Respir J. 1999, 13: 850-854. 10.1183/09031936.99.13485099.

    Article  PubMed  Google Scholar 

  13. Satta A, Migliori GB, Spanevello A, Neri M, Bottinelli R, Canepari M, Pellegrino MA, Reggiani C: Fiber types in skeletal muscles of chronic obstructive pulmonary disease patients related to respiratory function and exercise tolerance. Eur Respir J. 1997, 10: 2853-2860. 10.1183/09031936.97.10122853.

    Article  PubMed  Google Scholar 

  14. Jobin J, Maltais F, Doyon JF, LeBlanc P, Simard PM, Simard AA, Simard : Chronic obstructive pulmonary disease capillarity and fiber-type characteristics of skeletal muscle. J Cardiopulm Rehab. 1998, 18: 432-437. 10.1097/00008483-199811000-00005.

    Article  Google Scholar 

  15. Jakobsson P, Jorfeldt L, Brundin A: Skeletal muscle metabolites and fiber types in patients with advanced chronic obstructive pulmonary disease (COPD), with and without chronic respiratory failure. Eur Respir J. 1990, 3: 192-196.

    PubMed  Google Scholar 

  16. Jakobsson P, Jorfeldt L, Henriksson J: Metabolic enzyme activity in the quadriceps femoris muscle in patients with severe chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1995, 151: 374-377.

    Article  PubMed  Google Scholar 

  17. Maltais F, Simard AA, Simard C, Jobin J, Desgagnes P, LeBlanc P: Oxidative capacity of the skeletal muscle and lactic acid kinetics during exercise in normal subjects and in patients with COPD. Am J Respir Crit Care Med. 1996, 153: 288-293.

    Article  PubMed  Google Scholar 

  18. Maltais F, LeBlanc P, Whittom F, Simard C, Marquis K, Belanger M, Breton M-J, Jobin J: Oxidative enzyme activities of the vastus lateralis muscle and the functional status in patients with COPD. Thorax. 2000, 55: 848-853. 10.1136/thorax.55.10.848.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Sauleda J, Garcia-Palmer F, Wiesner RJ, Tarraga S, Harting I, Tomas P, Gomez C, Saus C, Palou A, Agusti AGN: Cytochrome oxidase activity and mitochondrial gene expression in skeletal muscle of patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1998, 157: 1413-1417.

    Article  PubMed  Google Scholar 

  20. Sala E, Roca J, Marrades RM, Alonso J, Gonzalez de Suso JM, Moreno A, Barbera JA, Nadal J, de Jover L, Rodriguez-Roisin R, Wagner PD: Effects of endurance training on skeletal muscle bioenergetics in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1999, 159: 1726-1734.

    Article  PubMed  Google Scholar 

  21. Kutsuzawa T, Shioya S, Kurita D, Haida M, Ohta Y, Yamabayashi H: Muscle energy metabolism and nutritional status in patients with chronic obstructive pulmonary disease. A 31P magnetic resonance study. Am J Respir Crit Care Med. 1995, 152: 647-652.

    Article  PubMed  Google Scholar 

  22. Tada H, Kato H, Misawa T, Sasaki F, Hayashi S, Takahashi Y, Kutsumi Y, Ishizaki T, Nakai T, Miyabo S: 31P-nuclear magnetic resonance evidence of abnormal skeletal muscle metabolism in patients with chronic lung disease and congestive heart failure. Eur Respir J. 1992, 5: 163-169.

    PubMed  Google Scholar 

  23. Thompson CH, Davies RJO, Kemp GJ, Taylor DJ, Radda GK, Rajagopalan B: Skeletal muscle metabolism during exercise and recovery in patients with respiratory failure. Thorax. 1993, 48: 486-490.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Payen JF, Wuyam B, Levy P, Reutenauer H, Stieglitz P, Paramelle B, Le Bas J-F: Muscular metabolism during oxygen supplementation in patients with chronic hypoxemia. Am Rev Respir Dis. 1993, 147: 592-598.

    Article  PubMed  Google Scholar 

  25. Wuyam B, Payen JF, Levy P, Bensaidane H, Reutenauer H, LeBas JF, Benabid AL: Metabolism and aerobic capacity of skeletal muscle in chronic respiratory failure related to chronic obstructive pulmonary disease. Eur Respir J. 1992, 5: 157-162.

    PubMed  Google Scholar 

  26. Casaburi R, Patessio A, Ioli F, Zanaboni S, Donner CF, Wasserman K: Reductions in exercise lactic acidosis and ventilation as a result of exercise training in patients with obstructive lung disease. Am Rev Respir Dis. 1991, 143: 9-18.

    Article  PubMed  Google Scholar 

  27. Maltais F, Jobin J, Sullivan MJ, Bernard S, Whittom F, Killian KJ, Desmeules M, Belanger M, LeBlanc P: Metabolic and hemodynamic responses of lower limb during exercise in patients with COPD. J Appl Physiol. 1998, 84: 1573-1580.

    PubMed  Google Scholar 

  28. Saltin B, Gollnick PD: Skeletal muscle adaptability: significance for metabolism and performance. In: Handbook of Physiology: Skeletal Muscle. Edited by Peachey LD. Washington, DC: American Physiological Society,. 1986, : 555-631.

    Google Scholar 

  29. Casaburi R: Deconditioning. In: Pulmonary Rehabilitation. Edited by Fishman AP. New York: Marcel Dekker,. 1996, : 213-230.

    Google Scholar 

  30. Coyle EF, Martin WH, Bloomfield SA, Lowry DH, Holloszy JO: Effects of detraining on responses to submaximal exercise. J Appl Physiol. 1985, 59: 853-859.

    PubMed  Google Scholar 

  31. Larsson L, Ansved T: Effects of long-term physical training and detraining on enzyme histochemical and functional skeletal muscle characteristic in man. Muscle Nerve. 1985, 8: 714-722.

    Article  PubMed  Google Scholar 

  32. Decramer M, de Bock V, Dom R: Functional and histologic picture of steroid-induced myopathy in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1996, 153: 1958-1964.

    Article  PubMed  Google Scholar 

  33. Decramer M, Lacquet LM, Fagard R, Rogiers P: Corticosteroids contribute to muscle weakness in chronic airflow obstruction. Am J Respir Crit Care Med. 1994, 150: 11-16.

    Article  PubMed  Google Scholar 

  34. Howald H, Pette D, Simoneau JA, Uber A, Hoppeler H, Cerretelli P: Effect of chronic hypoxia on muscle enzyme activities. Int J Sports Med. 1990, 11: 510-514.

    Article  Google Scholar 

  35. Corbucci GG, Menichetti A, Cogliati A, Ruvolo C: Metabolic aspects of cardiac and skeletal muscle tissues in the condition of hypoxia, ischaemia and reperfusion induced by extra-corporeal circulation. Int J Tissue React. 1995, 17: 219-225.

    PubMed  Google Scholar 

  36. Bigard AX, Brunet A, Guezennec CY, Monod H: Effects of chronic hypoxia and endurance training on muscle capillarity in rats. Pflugers Arch. 1991, 419: 225-229.

    Article  PubMed  Google Scholar 

  37. Hoppeler H, Kleinert E, Schlegel C, Claassen H, Howald H, Kayar SR, Cerretelli P: Morphological adaptations of human skeletal muscle to chronic hypoxia. Int J Sports Med. 1990, 11(suppl 1): S3-S9.

    Article  Google Scholar 

  38. Mador MJ, Wendel T, Kufel TJ: Effect of acute hypercapnia on diaphragmatic and limb muscle contractility. Am J Respir Crit Care Med. 1997, 155: 1590-1595.

    Article  PubMed  Google Scholar 

  39. Vianna LG, Koulouris N, Lanigan C, Moxham J: Effect of acute hypercapnia on limb muscle contractility in humans. J Appl Physiol. 1990, 69: 1486-1493.

    PubMed  Google Scholar 

  40. Gertz I, Hedenstierna G, Hellers G, Wahren J: Muscle metabolism in patients with chronic obstructive lung disease and acute respiratory failure. Clin Sci Mol Med. 1977, 52: 396-403.

    PubMed  Google Scholar 

  41. Fiaccadori E, Del Canale S, Vitali P, Coffrini E, Ronda N, Guariglia A: Skeletal muscle energetics, acid-base equilibrium and lactate metabolism in patients with severe hypercapnia and hypoxemia. Chest. 1987, 92: 883-887.

    Article  PubMed  Google Scholar 

  42. Schols AMWJ, Soeters PB, Dingemans AMC, Mostert R, Frantzen PJ, Wouters EFM: Prevalence and characteristics of nutritional depletion in patients with stable COPD eligible for pulmonary rehabilitation. Am Rev Respir Dis. 1993, 147: 1151-1156.

    Article  PubMed  Google Scholar 

  43. McLoughlin DM, Spargo E, Wassif WS, Newham DJ, Peters TJ, Lantos PL, Russell GF: Structural and functional changes in skeletal muscle in anorexia nervosa. Acta Neuropathol. 1998, 95: 632-640. 10.1007/s004010050850.

    Article  PubMed  Google Scholar 

  44. Engelen MAM, Schols AMWJ, Baken WC, Wesseling GJ, Wouters EFM: Nutritional depletion in relation to respiratory and peripheral skeletal muscle function in an outpatient population with chronic obstructive pulmonary disease. Eur Respir J. 1994, 7: 1793-1797. 10.1183/09031936.94.07101793.

    Article  PubMed  Google Scholar 

  45. Lopes J, Russell DM, Whitwell J, Jeejeebhoy KN: Skeletal muscle function in malnutrition. Am J Clin Nutr. 1982, 36: 602-610.

    PubMed  Google Scholar 

  46. Essen B, Fohlin L, Thoren C, Saltin B: Skeletal muscle fiber types and sizes in anorexia nervosa patients. Clin Physiol. 1981, 1: 395-403.

    Article  PubMed  Google Scholar 

  47. Mijan de la Torre A, Madapallimattam A, Cross A, Armstrong RL, Jeejeebhoy KN: Effect of fasting, hypocaloric feeding, and refeeding on the energetics of stimulated rat muscle as assessed by nuclear magnetic resonance spectroscopy. J Clin Invest. 1993, 92: 114-121.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Russell DM, Atwood HL, Whittaker JS, Itakura T, Walker PM, Mickle DA, Jeejeebhoy KN: The effect of fasting and hypocaloric diets on the functional and metabolic characteristics of rat gastrocnemius muscle. Clin Sci. 1984, 67: 185-194.

    Article  PubMed  Google Scholar 

  49. Rahman I, Morrison D, Donaldson K, Macnee W: Systemic oxidative stress in asthma, COPD, and smokers. Am J Respir Crit Care Med. 1996, 154: 1055-1060.

    Article  PubMed  Google Scholar 

  50. Ji LL: Exercise, oxidative stress, and antioxidants. Am J Sports Med. 1996, 24: 520-524.

    Google Scholar 

  51. Giuliani A, Cestaro B: Exercise, free radical generation and vitamins. Eur J Cancer Prev. 1997, 6: 555-567.

    Article  Google Scholar 

  52. Di Francia M, Barbier D, Mege JL, Orehek J: Tumor necrosis factor-a levels and weight loss in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1994, 150: 1453-1455.

    Article  PubMed  Google Scholar 

  53. de Godoy I, Donahoe M, Calhoun WJ, Mancino J, Rogers RM: Elevated TNF-alpha production by peripheral blood monocytes of weight-losing COPD patients. Am J Respir Crit Care Med. 1996, 153: 633-637.

    Article  PubMed  Google Scholar 

  54. Howard H, Hoppeler H, Claassen H, Mathieu O, Stroub R: Influences of endurance training on the ultrastructural composition of the different muscle fiber types in humans. Pflugers Arch. 1985, 403: 369-376.

    Article  Google Scholar 

  55. American College of Sports Medicine: The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness in healthy adults. Med Sci Sports Exerc. 1990, 22: 265-274.

    Google Scholar 

  56. Belman MJ, Kendregan BA: Exercise training fails to increase skeletal muscle enzymes in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis. 1981, 123: 256-261.

    PubMed  Google Scholar 

  57. Maltais F, LeBlanc P, Simard C, Jobin J, Berube C, Bruneau J, Carrier L, Belleau R: Skeletal muscle adaptation to endurance training in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1996, 154: 442-447.

    Article  PubMed  Google Scholar 

  58. Serres I, Varray A, Vallet G, Micallef JP, Prefaut C: Improved skeletal muscle performance after individualized exercise training in patients with chronic obstructive pulmonary disease. J Cardiopulm Rehab. 1997, 17: 232-238. 10.1097/00008483-199707000-00003.

    Article  Google Scholar 

  59. Ries AL, Kaplan RM, Limberg TM, Prewit LM: Effect of pulmonary rehabilitation on physiologic and psychological outcomes in patients with chronic obstructive pulmonary disease. Ann Intern Med. 1995, 122: 823-832.

    Article  PubMed  Google Scholar 

  60. Goldstein RS, Gort ED, Stubbing D, Avendano MA, Guyatt GH: Randomized controlled trial of respiratory rehabilitation. Lancet. 1994, 344: 1394-1397. 10.1016/S0140-6736(94)90568-1.

    Article  PubMed  Google Scholar 

  61. Casaburi R, Porszasz J, Burns MR, Carithers E, Chang RSY, Cooper CB: Physiologic benefits of exercise training in rehabilitation of patients with severe chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1997, 155: 1541-1551.

    Article  PubMed  Google Scholar 

  62. Casaburi R, Storer TW, Sullivan CS, Wasserman K: Evaluation of blood lactate elevation as an intensity criterion for exercise training. Med Sci Sports Exerc. 1995, 27: 852-862.

    Article  PubMed  Google Scholar 

  63. Lacasse Y, Guyatt GH, Goldstein RS: The components of a respiratory rehabilitation program. A systematic overview. Chest. 1997, 111: 1077-1088.

    Article  PubMed  Google Scholar 

  64. Bernard S, Whittom F, LeBlanc P, Jobin J, Belleau R, Berube C, Carrier G, Maltais F: Aerobic and strength training in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1999, 159: 896-901.

    Article  PubMed  Google Scholar 

  65. Cotes JE, Gilson JC: Effect of oxygen on exercise ability in chronic respiratory insufficiency. Lancet. 1956, 1: 872-876. 10.1016/S0140-6736(56)91341-1.

    Article  Google Scholar 

  66. Stein DA, Bradley BL, Miller WC: Mechanisms of oxygen effects on exercise in patients with chronic obstructive pulmonary disease. Chest. 1982, 81: 6-10.

    Article  PubMed  Google Scholar 

  67. Jakobsson P, Jorfeldt L: Long-term oxygen therapy may improve skeletal muscle metabolism in advanced chronic obstructive pulmonary disease patients with chronic hypoxemia. Respir Med. 1995, 89: 471-476.

    Article  PubMed  Google Scholar 

  68. Mannix ET, Boska MD, Galassetti P, Burton G, Manfredi F, Farber MO: Modulation of ATP production by oxygen in obstructive lung disease as assessed by 31P-MRS. J Appl Physiol. 1995, 78: 2218-2227.

    PubMed  Google Scholar 

  69. Rooyackers JM, Dekhuijzen PN, Van Herwaarden CL, Folgering HT: Training with supplemental oxygen in patients with COPD and hypoxemia at peak exercise. Eur Respir J. 1997, 10: 1278-1284. 10.1183/09031936.97.10061278.

    Article  PubMed  Google Scholar 

  70. Callahan CM, Dittus RS, Katz BP: Oral corticosteriod therapy for patients with stable chronic obstructive pulmonary disease. A meta-analysis. Ann Intern Med. 1991, 114: 216-223.

    Article  PubMed  Google Scholar 

  71. Niewoehner DE, Erbland ML, Deupree RH, Collins D, Gross NJ, Light RW, Anderson P, Morgan NA: Effect of systemic glucocorticoids on exacerbations of chronic obstructive pulmonary disease. Department of Veterans Affairs Cooperative Study Group. N Engl J Med. 1999, 340: 1941-1947. 10.1056/NEJM199906243402502.

    Article  PubMed  Google Scholar 

  72. Gray-Donald K, Gibbons L, Shapiro SH, Macklem PT, Martin JG: Nutritional status and mortality in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1996, 153: 961-966.

    Article  PubMed  Google Scholar 

  73. Shoup R, Dalsky G, Warner S, Davies M, Connors M, Khan M, Khan F, ZuWallack R: Body composition and health-related quality of life in patients with obstructive airways disease. Eur Respir J. 1997, 10: 1576-1580. 10.1183/09031936.97.10071576.

    Article  PubMed  Google Scholar 

  74. Ferreira IM, Brooks D, Lacasse Y, Goldstein RS: Nutritional support for individuals with COPD. A meta-analysis. Chest. 2000, 117: 672-678. 10.1378/chest.117.3.672.

    Article  PubMed  Google Scholar 

  75. Donahoe M, Mancino J, Costantino J, Lebow H, Rogers RM: The effect of an aggressive nutritional support regimen on body composition in patients with severe COPD and weight loss [abstract]. Am J Respir Crit Care Med. 1994, 149: A313-

    Google Scholar 

  76. Schols AMWJ, Soeters PB, Mostert R, Pluymers RJ, Wouters EFM: Physiologic effects of nutritional support and anabolic steroids in patients with chronic obstructive pulmonary disease. A placebo-controlled randomized trial. Am J Respir Crit Care Med. 1995, 152: 1268-1274.

    Article  PubMed  Google Scholar 

  77. Cuneo RC, Salomon F, Wiles CM, Hesp R, Sonksen PH: Growth hormone treatment in growth hormone-deficient adults. I. Effects on muscle mass and strength. J Appl Physiol. 1991, 70: 688-694.

    PubMed  Google Scholar 

  78. Cuneo RC, Salomon F, Wiles CM, Hesp R, Sonksen PH: Growth hormone treatment in growth hormone-deficient adults. Il. Effects on exercise performance. J Appl Physiol. 1991, 70: 695-700.

    PubMed  Google Scholar 

  79. Taaffe DR, Pruitt L, Reim J, Hintz RL, Butterfield G, Hoffman AR, Marcus R: Effect of recombinant human growth hormone on the muscle strength response to resistance exercise in elderly men. J Clin Endocrinol Metab. 1994, 79: 1361-1366.

    PubMed  Google Scholar 

  80. Papadakis MA, Grady D, Black D, Tierney MJ, Gooding GA, Schambelan M, Grunfeld C: Growth hormone replacement in healthy older men improves body composition but not functional ability. Ann Intern Med. 1996, 124: 708-716.

    Article  PubMed  Google Scholar 

  81. Burdet L, de Muralt B, Schutz Y, Pichard C, Fitting JW: Administration of growth hormone to underweight patients with chronic obstructive pulmonary disease. A prospective, randomized, controlled study. Am J Respir Crit Care Med. 1997, 156: 1800-1806.

    Article  PubMed  Google Scholar 

  82. Casaburi R, Carithers E, Tosolini J, Phillips J, Bhasin S: Randomized placebo controlled trial of growth hormone in severe COPD patients undergoing endurance exercise training [abstract]. Am J Respir Crit Care Med. 1997, 155: A498-

    Google Scholar 

  83. Bhasin S, Storer TW, Berman N, Yarasheski KE, Clevenger B, Phillips J, Lee WP, Bunnell TJ, Casaburi R: Testosterone replacement increases fat-free mass and muscle size in hypogonadal men. J Clin Endocrinol Metab. 1997, 82: 407-413.

    PubMed  Google Scholar 

  84. Sih R, Morley JE, Kaiser FE, Perry HM, Patrick P, Ross C: Testosterone replacement in older hypogonadal men: a 12-month randomized controlled trial. J Clin Endocrinol Metab. 1997, 82: 1661-1667.

    Article  PubMed  Google Scholar 

  85. Bhasin S, Storer TW, Berman N, Callegari C, Clevenger B, Phillips J, Bunnell TJ, Tricker R, Shirazi A, Casaburi R: The effects of supraphysiologic doses of testosterone on muscle size and strength in normal men. N Engl J Med. 1996, 335: 1-7. 10.1056/NEJM199607043350101.

    Article  PubMed  Google Scholar 

  86. Urban RJ, Bodenburg YH, Gilkison C, Foxworth J, Coggan AR, Wolfe RR, Ferrando A: Testosterone administration to elderly men increases skeletal muscle strength and protein synthesis. Am J Physiol. 1995, 269: E820-E826.

    PubMed  Google Scholar 

  87. Segal JM, Laghi F, Choe W, Desai K, Jubran A, Tobin MJ: Prevalence of hypogonadism in patients with chronic obstructive pulmonary disease [abstract]. Am J Respir Crit Care Med. 2000, 161: A232-

    Article  Google Scholar 

  88. Ferreira IM, Verreschi IT, Nery LE, Goldstein RS, Zamel N, Brooks D, Jardim JR: The influence of 6 months of oral anabolic steroids on body mass and respiratory muscles in undernourished COPD patients. Chest. 1998, 114: 19-28.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Pulmonary, Critical Care & Sleep Medicine, State University of New York at Buffalo, Veterans Administration Medical Center, Section 111S, 3495 Bailey Avenue, NY 14215, Buffalo, New York, USA

    M Jeffery Mador

  2. GATA Camlica Hospital of Chest Diseases, Istanbul, Turkey

    Erkan Bozkanat

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  1. M Jeffery Mador
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Jeffery Mador, M., Bozkanat, E. Skeletal muscle dysfunction in chronic obstructive pulmonary disease. Respir Res 2, 216 (2001). https://doi.org/10.1186/rr60

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