{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T16:33:53Z","timestamp":1793378033859,"version":"4.5.0"},"reference-count":41,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","resmedjournal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Respiratory Medicine"],"published-print":{"date-parts":[[2026,9]]},"DOI":"10.1016\/j.rmed.2026.108992","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T06:39:37Z","timestamp":1782455977000},"page":"108992","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Quantitative CT\u2013Derived extrapulmonary body composition and the risk of acute exacerbations in COPD: A prospective cohort study"],"prefix":"10.1016","volume":"261","author":[{"given":"Chengyu","family":"Miao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengchuan","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5737-0625","authenticated-orcid":false,"given":"Fengyan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6907-592X","authenticated-orcid":false,"given":"Yuqiong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zizheng","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueping","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zifei","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangcheng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongchang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8746-315X","authenticated-orcid":false,"given":"Zhenyu","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.rmed.2026.108992_bib1","doi-asserted-by":"crossref","DOI":"10.1177\/1753466620942128","article-title":"Early COPD: current evidence for diagnosis and management","volume":"14","author":"Fazleen","year":"2020","journal-title":"Ther. Adv. Respir. Dis."},{"issue":"1","key":"10.1016\/j.rmed.2026.108992_bib2","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1111\/resp.12660","article-title":"Global burden of COPD","volume":"21","author":"Lopez-Campos","year":"2016","journal-title":"Respirology"},{"issue":"6","key":"10.1016\/j.rmed.2026.108992_bib3","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/S2213-2600(20)30105-3","article-title":"Prevalence and attributable health burden of chronic respiratory diseases, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017","volume":"8","year":"2020","journal-title":"Lancet Respir. Med."},{"issue":"4","key":"10.1016\/j.rmed.2026.108992_bib4","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1164\/rccm.201710-2029OC","article-title":"Natural history of chronic obstructive pulmonary disease exacerbations in a general practice-based population with chronic obstructive pulmonary disease","volume":"198","author":"Rothnie","year":"2018","journal-title":"Am. J. Respir. Crit. Care Med."},{"issue":"3","key":"10.1016\/j.rmed.2026.108992_bib5","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1164\/rccm.201605-1014OC","article-title":"Acute exacerbations and lung function loss in smokers with and without chronic obstructive pulmonary disease","volume":"195","author":"Dransfield","year":"2017","journal-title":"Am. J. Respir. Crit. Care Med."},{"issue":"10","key":"10.1016\/j.rmed.2026.108992_bib6","doi-asserted-by":"crossref","first-page":"5784","DOI":"10.21037\/jtd-23-1421","article-title":"The utility of quantitative computed tomography in cohort studies of chronic obstructive pulmonary disease: a narrative review","volume":"15","author":"Dai","year":"2023","journal-title":"J. Thorac. Dis."},{"key":"10.1016\/j.rmed.2026.108992_bib7","article-title":"Quantitative assessment of erector spinae muscles in patients with COPD: novel chest CT-derived index for prognosis","author":"Tanimura","year":"2015","journal-title":"Ann. Am. Thorac. Soc."},{"key":"10.1016\/j.rmed.2026.108992_bib8","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2022.1087110","article-title":"Accelerated loss of trunk muscle density and size at L1 vertebral level in male patients with COPD","volume":"13","author":"Wang","year":"2022","journal-title":"Front. Endocrinol."},{"issue":"130","key":"10.1016\/j.rmed.2026.108992_bib9","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1183\/09059180.00008612","article-title":"Comorbidities of COPD","volume":"22","author":"Cavailles","year":"2013","journal-title":"Eur. Respir. Rev."},{"issue":"3","key":"10.1016\/j.rmed.2026.108992_bib10","doi-asserted-by":"crossref","first-page":"1736","DOI":"10.21037\/jtd-24-1074","article-title":"Quantitative CT evaluation of extrapulmonary lesions in chronic obstructive pulmonary disease: a narrative review","volume":"17","author":"Miao","year":"2025","journal-title":"J. Thorac. Dis."},{"issue":"3","key":"10.1016\/j.rmed.2026.108992_bib11","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1513\/AnnalsATS.201307-229OC","article-title":"Quantitative computed tomography measures of pectoralis muscle area and disease severity in chronic obstructive pulmonary disease. A cross-sectional study","volume":"11","author":"McDonald","year":"2014","journal-title":"Ann. Am. Thorac. Soc."},{"issue":"3","key":"10.1016\/j.rmed.2026.108992_bib12","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1148\/radiol.2021203959","article-title":"Quantitative analysis of adipose depots by using chest CT and associations with all-cause mortality in chronic obstructive pulmonary disease: longitudinal analysis from MESArthritis ancillary study","volume":"299","author":"Pishgar","year":"2021","journal-title":"Radiology"},{"issue":"1","key":"10.1016\/j.rmed.2026.108992_bib13","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1186\/s12931-022-02237-w","article-title":"Increased chest CT derived bone and muscle measures capture markers of improved morbidity and mortality in COPD","volume":"23","author":"Wilson","year":"2022","journal-title":"Respir. Res."},{"issue":"4","key":"10.1016\/j.rmed.2026.108992_bib14","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1111\/resp.14223","article-title":"Chest CT-assessed comorbidities and all-cause mortality risk in COPD patients in the BODE cohort","volume":"27","author":"Ezponda","year":"2022","journal-title":"Respirology"},{"issue":"1","key":"10.1016\/j.rmed.2026.108992_bib15","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.chest.2020.08.2053","article-title":"CT imaging and comorbidities in COPD: beyond lung cancer screening","volume":"159","author":"Singhvi","year":"2021","journal-title":"Chest"},{"issue":"1","key":"10.1016\/j.rmed.2026.108992_bib16","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/S2213-2600(23)00461-7","article-title":"GOLD COPD report: 2024 update","volume":"12","author":"Venkatesan","year":"2024","journal-title":"Lancet Respir. Med."},{"issue":"8","key":"10.1016\/j.rmed.2026.108992_bib17","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1136\/thoraxjnl-2012-203151","article-title":"Coronary artery calcification is increased in patients with COPD and associated with increased morbidity and mortality","volume":"69","author":"Williams","year":"2014","journal-title":"Thorax"},{"issue":"21","key":"10.1016\/j.rmed.2026.108992_bib18","doi-asserted-by":"crossref","DOI":"10.3390\/jcm10215014","article-title":"Circulating extracellular vesicles are associated with disease severity and Interleukin-6 levels in COPD: a pilot study","volume":"10","author":"Nieri","year":"2021","journal-title":"J. Clin. Med."},{"key":"10.1016\/j.rmed.2026.108992_bib19","article-title":"Association of pectoralis muscle area on computed tomography with airflow limitation severity and respiratory outcomes in COPD: a population-based prospective cohort study","author":"Zhou","year":"2023","journal-title":"Pulmonology"},{"issue":"5","key":"10.1016\/j.rmed.2026.108992_bib20","doi-asserted-by":"crossref","DOI":"10.1177\/03000605221094644","article-title":"Associations between bone mineral density and chronic obstructive pulmonary disease","volume":"50","author":"Zhang","year":"2022","journal-title":"J. Int. Med. Res."},{"issue":"1","key":"10.1016\/j.rmed.2026.108992_bib21","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1007\/s12013-014-9868-9","article-title":"Bone metabolism status and associated risk factors in elderly patients with chronic obstructive pulmonary disease (COPD)","volume":"70","author":"Xiaomei","year":"2014","journal-title":"Cell Biochem. Biophys."},{"issue":"5\u20136","key":"10.1016\/j.rmed.2026.108992_bib22","first-page":"321","article-title":"The association of bone mineral density with mortality in a COPD cohort. The HUNT study, Norway","volume":"16","author":"Vikjord","year":"2019","journal-title":"COPD J. Chronic Obstr. Pulm. Dis."},{"issue":"5","key":"10.1016\/j.rmed.2026.108992_bib23","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1097\/RCT.0000000000000119","article-title":"Coronary artery calcification on computed tomography correlates with mortality in chronic obstructive pulmonary disease","volume":"38","author":"O'Hare","year":"2014","journal-title":"J. Comput. Assist. Tomogr."},{"issue":"1","key":"10.1016\/j.rmed.2026.108992_bib24","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1080\/17476348.2021.1843429","article-title":"Role of acute exacerbations in skeletal muscle impairment in COPD","volume":"15","author":"Gosker","year":"2021","journal-title":"Expert Rev. Respir. Med."},{"issue":"9","key":"10.1016\/j.rmed.2026.108992_bib25","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1152\/japplphysiol.00847.2012","article-title":"Mechanisms of striated muscle dysfunction during acute exacerbations of COPD","volume":"114","author":"Gayan-Ramirez","year":"1985","journal-title":"J. Appl. Physiol."},{"issue":"3","key":"10.1016\/j.rmed.2026.108992_bib26","first-page":"235","article-title":"Impact of COPD exacerbations on osteoporosis assessed by chest CT scan","volume":"9","author":"Kiyokawa","year":"2012","journal-title":"COPD J. Chronic Obstr. Pulm. Dis."},{"key":"10.1016\/j.rmed.2026.108992_bib27","doi-asserted-by":"crossref","DOI":"10.3389\/fmed.2023.1214277","article-title":"Prevalence, predictors, dynamic bone change, and treatment efficacy of osteoporosis among chronic obstructive pulmonary disease patients: a prospective cohort study","volume":"10","author":"Kaenmuang","year":"2023","journal-title":"Front. Med."},{"issue":"2","key":"10.1016\/j.rmed.2026.108992_bib28","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.jcmg.2021.07.012","article-title":"Deep learning for automatic calcium scoring in population-based cardiovascular screening","volume":"15","author":"Vonder","year":"2022","journal-title":"JACC, Cardiovasc. Imaging"},{"issue":"1","key":"10.1016\/j.rmed.2026.108992_bib29","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1007\/s12350-022-02940-7","article-title":"Fully automated deep learning powered calcium scoring in patients undergoing myocardial perfusion imaging","volume":"30","author":"Sartoretti","year":"2023","journal-title":"J. Nucl. Cardiol."},{"issue":"10","key":"10.1016\/j.rmed.2026.108992_bib30","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1164\/rccm.202209-1748SO","article-title":"Phenotypes, etiotypes, and endotypes of exacerbations of chronic obstructive pulmonary disease","volume":"208","author":"Bhatt","year":"2023","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"10.1016\/j.rmed.2026.108992_bib31","doi-asserted-by":"crossref","DOI":"10.3389\/fphys.2022.833796","article-title":"CT attenuation and cross-sectional area of the pectoralis are associated with clinical characteristics in chronic obstructive pulmonary disease patients","volume":"13","author":"Qiao","year":"2022","journal-title":"Front. Physiol."},{"key":"10.1016\/j.rmed.2026.108992_bib32","doi-asserted-by":"crossref","first-page":"389","DOI":"10.2147\/COPD.S510425","article-title":"Skeletal muscle function in relation to COPD severity and its predictive significance for disease progression","volume":"20","author":"He","year":"2025","journal-title":"Int. J. Chronic Obstr. Pulm. Dis."},{"issue":"4","key":"10.1016\/j.rmed.2026.108992_bib33","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1152\/physrev.00063.2017","article-title":"Mechanisms of insulin action and insulin resistance","volume":"98","author":"Petersen","year":"2018","journal-title":"Physiol. Rev."},{"key":"10.1016\/j.rmed.2026.108992_bib34","doi-asserted-by":"crossref","DOI":"10.1155\/2010\/476279","article-title":"Pathogenesis of insulin resistance in skeletal muscle","volume":"2010","author":"Abdul-Ghani","year":"2010","journal-title":"J. Biomed. Biotechnol."},{"issue":"1","key":"10.1016\/j.rmed.2026.108992_bib35","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1007\/s12020-011-9583-x","article-title":"The association of low bone mineral density with systemic inflammation in clinically stable COPD","volume":"42","author":"Liang","year":"2012","journal-title":"Endocrine"},{"issue":"1","key":"10.1016\/j.rmed.2026.108992_bib36","doi-asserted-by":"crossref","first-page":"5245","DOI":"10.1038\/s41598-024-56114-1","article-title":"Using machine learning techniques to predict the risk of osteoporosis based on nationwide chronic disease data","volume":"14","author":"Tu","year":"2024","journal-title":"Sci. Rep."},{"issue":"1","key":"10.1016\/j.rmed.2026.108992_bib37","article-title":"Relationship between chronic obstructive pulmonary disease and osteoporosis: a scoping review","volume":"21","author":"Penedones","year":"2024","journal-title":"COPD J. Chronic Obstr. Pulm. Dis."},{"issue":"3","key":"10.1016\/j.rmed.2026.108992_bib38","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.resinv.2015.01.002","article-title":"Low arterial blood oxygenation is associated with calcification of the coronary arteries in patients with chronic obstructive pulmonary disease","volume":"53","author":"Inoue","year":"2015","journal-title":"Respir. Investig."},{"issue":"4\u20135","key":"10.1016\/j.rmed.2026.108992_bib39","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1080\/14779072.2024.2333786","article-title":"Cardiovascular disease and risk in COPD: a state of the art review","volume":"22","author":"Polman","year":"2024","journal-title":"Expert Rev. Cardiovasc Ther."},{"issue":"2","key":"10.1016\/j.rmed.2026.108992_bib40","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1007\/s10557-014-6569-y","article-title":"Chronic obstructive pulmonary disease and ischemic heart disease comorbidity: overview of mechanisms and clinical management","volume":"29","author":"Campo","year":"2015","journal-title":"Cardiovasc. Drugs Ther."},{"key":"10.1016\/j.rmed.2026.108992_bib41","doi-asserted-by":"crossref","DOI":"10.1016\/j.rmed.2021.106540","article-title":"Qualitative coronary artery calcification scores and risk of all cause, COPD and pneumonia hospital admission in a large CT lung cancer screening cohort","volume":"186","author":"Gazourian","year":"2021","journal-title":"Respir. Med."}],"container-title":["Respiratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0954611126003604?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0954611126003604?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T15:40:34Z","timestamp":1793374834000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0954611126003604"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":41,"alternative-id":["S0954611126003604"],"URL":"https:\/\/doi.org\/10.1016\/j.rmed.2026.108992","relation":{},"ISSN":["0954-6111"],"issn-type":[{"value":"0954-6111","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Quantitative CT\u2013Derived extrapulmonary body composition and the risk of acute exacerbations in COPD: A prospective cohort study","name":"articletitle","label":"Article Title"},{"value":"Respiratory Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.rmed.2026.108992","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"108992"}}