Diagnostic Methods for Muscle Wasting in COPD: Strengths, Limitations and the Role of Nutritional Assessment
4 affiliations
- 1Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
- 2U.O.C. Clinica Pneumologica L. Vanvitelli, A.O. dei Colli, Monaldi Hospital, Via Leonardo Bianchi, 80131 Naples, Italy
- 3Department of Molecular Medicine and Medical Biotechnologies, University of Naples “Federico II”, 80131 Naples, Italy
- 4Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
Abstract
Background/Objectives: Skeletal muscle wasting is a frequent and clinically consequential comorbidity in COPD, affecting 15–50% of patients and predicting reduced exercise tolerance, impaired quality of life, hospitalization, and mortality. However, no consensus exists on the optimal diagnostic approach, and the role of nutritional assessment remains underemphasized despite its contribution to muscle depletion. Methods: This narrative review synthesizes evidence from original research, systematic reviews, and consensus statements on diagnostic methods for evaluating muscle mass, strength, physical performance, and nutritional status in COPD. Results: Computed tomography and magnetic resonance imaging offer accurate assessment of muscle mass but are limited by cost and accessibility. Dual-energy X-ray absorptiometry provides a low-radiation alternative but cannot assess muscle quality. Bioelectrical impedance analysis and ultrasound are portable and inexpensive, yet lack standardized COPD-specific cut-offs. Functional tests provide clinically meaningful performance data but do not directly measure muscle mass. In parallel, nutritional screening tools and dietary assessment can identify modifiable risk factors and are associated with sarcopenia prevalence and prognosis in COPD. The choice of diagnostic approach significantly influences prevalence estimates. Conclusions: Optimal assessment of muscle wasting in COPD requires a multimodal approach combining muscle mass quantification, strength measurement, physical performance evaluation, and nutritional assessment. Standardized COPD-specific diagnostic criteria are needed. A practical algorithm integrating simple screening tools with targeted confirmatory assessments, including nutritional evaluation, may help guide clinical practice.
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BibTeX
@article{cianci2026diagnostic,
title = {{Diagnostic Methods for Muscle Wasting in COPD: Strengths, Limitations and the Role of Nutritional Assessment}},
author = {Roberta Cianci and Domenica Francesca Mariniello and Giuseppe Luciano and Filippo Scialò and Luigi Aronne and Grazia Mazzeo and Alfredo Cipriano and Susan F. Campbell and Fabio Perrotta and Andrea Bianco and Raffaella Pagliaro},
journal = {Nutrients},
year = {2026},
month = oct,
doi = {10.3390/nu18203440},
url = {https://www.mdpi.com/2072-6643/18/20/3440},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Diagnostic Methods for Muscle Wasting in COPD: Strengths, Limitations and the Role of Nutritional Assessment
AU - Roberta Cianci
AU - Domenica Francesca Mariniello
AU - Giuseppe Luciano
AU - Filippo Scialò
AU - Luigi Aronne
AU - Grazia Mazzeo
AU - Alfredo Cipriano
AU - Susan F. Campbell
AU - Fabio Perrotta
AU - Andrea Bianco
AU - Raffaella Pagliaro
PY - 2026
DA - 2026/10/20
JO - Nutrients
DO - 10.3390/nu18203440
UR - https://www.mdpi.com/2072-6643/18/20/3440
AB - Background/Objectives: Skeletal muscle wasting is a frequent and clinically consequential comorbidity in COPD, affecting 15–50% of patients and predicting reduced exercise tolerance, impaired quality of life, hospitalization, and mortality. However, no consensus exists on the optimal diagnostic approach, and the role of nutritional assessment remains underemphasized despite its contribution to muscle depletion. Methods: This narrative review synthesizes evidence from original research, systematic reviews, and consensus statements on diagnostic methods for evaluating muscle mass, strength, physical performance, and nutritional status in COPD. Results: Computed tomography and magnetic resonance imaging offer accurate assessment of muscle mass but are limited by cost and accessibility. Dual-energy X-ray absorptiometry provides a low-radiation alternative but cannot assess muscle quality. Bioelectrical impedance analysis and ultrasound are portable and inexpensive, yet lack standardized COPD-specific cut-offs. Functional tests provide clinically meaningful performance data but do not directly measure muscle mass. In parallel, nutritional screening tools and dietary assessment can identify modifiable risk factors and are associated with sarcopenia prevalence and prognosis in COPD. The choice of diagnostic approach significantly influences prevalence estimates. Conclusions: Optimal assessment of muscle wasting in COPD requires a multimodal approach combining muscle mass quantification, strength measurement, physical performance evaluation, and nutritional assessment. Standardized COPD-specific diagnostic criteria are needed. A practical algorithm integrating simple screening tools with targeted confirmatory assessments, including nutritional evaluation, may help guide clinical practice.
SN - 2072-6643
ER -