{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T12:12:51Z","timestamp":1788783171666,"version":"build-2803163510"},"reference-count":50,"publisher":"European Respiratory Society (ERS)","issue":"5","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100015084","name":"Lung Foundation Netherlands","doi-asserted-by":"publisher","award":["5.1.18.232."],"award-info":[{"award-number":["5.1.18.232."]}],"id":[{"id":"10.13039\/501100015084","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["ERJ Open Res"],"accepted":{"date-parts":[[2026,3,24]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Preserved ratio impaired spirometry (PRISm) is a heterogeneous condition often accompanied by respiratory symptoms and increased mortality, affecting 5\u201324% of the general population. However, the prevalence of low muscle mass and related clinical characteristics in PRISm remain unknown. This study aimed to: 1) determine the prevalence of low appendicular skeletal muscle index (ASMI) in individuals with PRISm compared with normal spirometry and COPD; 2) describe characteristics of persons with PRISm with low or normal ASMI; and 3) investigate whether low ASMI in PRISm is associated with COPD development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In the Rotterdam Study, participants were classified as PRISm, COPD, or normal spirometry. Baseline characteristics and body composition (dual-energy radiograph absorptiometry-derived ASMI) were collected. Low ASMI was defined as &lt;7.0\u2005kg\u00b7m\n                      <jats:sup>\u22122<\/jats:sup>\n                      in males and &lt;5.5\u2005kg\u00b7m\n                      <jats:sup>\u22122<\/jats:sup>\n                      in females. Logistic regression assessed predictors of COPD development over \u223c5\u2005years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 5487 individuals, Low ASMI prevalence in PRISm was 8%, and was more common than in normal spirometry (4%). Among individuals with PRISm, 49% developed COPD over time. Compared to individuals with normal spirometry and normal ASMI, individuals with PRISm and low ASMI had a sevenfold higher risk of developing COPD adjusted for sex, age, and smoking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Low ASMI was more prevalent in PRISm compared to normal spirometry. PRISm at baseline and smoking were strongly associated with COPD development, with the highest risk in individuals with PRISm and low ASMI, suggesting that low ASMI in PRISm may be a treatable trait requiring clinical attention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1183\/23120541.01632-2025","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T15:45:24Z","timestamp":1776959124000},"page":"01632-2025","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Low appendicular muscle mass and the risk of COPD development in people with PRISm"],"prefix":"10.1183","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7590-616X","authenticated-orcid":false,"given":"Bente","family":"Brauwers","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3494-4363","authenticated-orcid":false,"given":"Lies","family":"Lahousse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7021-8505","authenticated-orcid":false,"given":"Guy","family":"Brusselle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8192-0543","authenticated-orcid":false,"given":"Rosanne J.H.C.G.","family":"Beijers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3822-7430","authenticated-orcid":false,"given":"Martijn A.","family":"Spruit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1633-6356","authenticated-orcid":false,"given":"Frits M.E.","family":"Franssen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"2026090704551284000_12.5.01632-2025.1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01217-2019"},{"key":"2026090704551284000_12.5.01632-2025.2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201804-0663OC"},{"key":"2026090704551284000_12.5.01632-2025.3","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2009.126052"},{"key":"2026090704551284000_12.5.01632-2025.4","doi-asserted-by":"publisher","DOI":"10.2310\/JIM.0b013e31822bb213"},{"key":"2026090704551284000_12.5.01632-2025.5","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/S2213-2600(21)00369-6","article-title":"Prevalence, risk factors, and clinical implications of preserved ratio impaired spirometry: a UK Biobank cohort analysis","volume":"10","author":"Higbee","year":"2022","journal-title":"Lancet Respir Med"},{"key":"2026090704551284000_12.5.01632-2025.6","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.1513\/AnnalsATS.201803-184OC","article-title":"Restrictive spirometry pattern, cardiac structure and function, and incident heart failure in African Americans. The Jackson heart study","volume":"15","author":"Jankowich","year":"2018","journal-title":"Ann Am Thorac Soc"},{"key":"2026090704551284000_12.5.01632-2025.7","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.atherosclerosis.2017.10.013","article-title":"Prospective study of lung function and abdominal aortic aneurysm risk: the atherosclerosis risk in communities study","volume":"268","author":"Kubota","year":"2018","journal-title":"Atherosclerosis"},{"key":"2026090704551284000_12.5.01632-2025.8","doi-asserted-by":"crossref","first-page":"2394","DOI":"10.1111\/jth.13525","article-title":"Lung function, respiratory symptoms and venous thromboembolism risk: the Atherosclerosis Risk in Communities Study","volume":"14","author":"Kubota","year":"2016","journal-title":"J Thromb Haemost"},{"key":"2026090704551284000_12.5.01632-2025.9","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2007.088112"},{"key":"2026090704551284000_12.5.01632-2025.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2008.02.021"},{"key":"2026090704551284000_12.5.01632-2025.11","first-page":"613","article-title":"Risk factors for prevalence of and mortality related to restriction on spirometry: findings from the First National Health and Nutrition Examination Survey and follow-up","volume":"9","author":"Mannino","year":"2005","journal-title":"Int J Tuberc Lung Dis"},{"key":"2026090704551284000_12.5.01632-2025.12","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.20939"},{"key":"2026090704551284000_12.5.01632-2025.13","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1186\/s12931-016-0468-7","article-title":"Spirometric variability in smokers: transitions in COPD diagnosis in a five-year longitudinal study","volume":"17","author":"Sood","year":"2016","journal-title":"Respir Res"},{"key":"2026090704551284000_12.5.01632-2025.14","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-2622"},{"key":"2026090704551284000_12.5.01632-2025.15","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/j.numecd.2015.12.013","article-title":"Abdominal adiposity is an early marker of pulmonary function impairment: findings from a Mediterranean Italian female cohort","volume":"26","author":"Vatrella","year":"2016","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"2026090704551284000_12.5.01632-2025.16","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-014-0089-y"},{"key":"2026090704551284000_12.5.01632-2025.17","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s40248-015-0003-6","article-title":"Change in prevalence of restrictive lung impairment in the U.S. population and associated risk factors: the National Health and Nutrition Examination Survey (NHANES) 1988\u20131994 and 2007\u20132010","volume":"10","author":"Kurth","year":"2015","journal-title":"Multidiscip Respir Med"},{"key":"2026090704551284000_12.5.01632-2025.18","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0011431"},{"key":"2026090704551284000_12.5.01632-2025.19","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-0324"},{"key":"2026090704551284000_12.5.01632-2025.20","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyl049"},{"key":"2026090704551284000_12.5.01632-2025.21","doi-asserted-by":"publisher","DOI":"10.1378\/chest.12-1411"},{"key":"2026090704551284000_12.5.01632-2025.22","doi-asserted-by":"crossref","first-page":"866","DOI":"10.3109\/08958378.2014.965560","article-title":"Respiratory symptoms, lung function decrement and chronic obstructive pulmonary disease in pre-menopausal Indian women exposed to biomass smoke","volume":"26","author":"Mukherjee","year":"2014","journal-title":"Inhal Toxicol"},{"key":"2026090704551284000_12.5.01632-2025.23","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1016\/j.chest.2024.12.025","article-title":"Preserved ratio impaired spirometry prevalence, risk factors, and outcomes: a systematic review and meta-analysis","volume":"167","author":"Robertson","year":"2025","journal-title":"Chest"},{"key":"2026090704551284000_12.5.01632-2025.24","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-0804"},{"key":"2026090704551284000_12.5.01632-2025.25","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2014-206440"},{"key":"2026090704551284000_12.5.01632-2025.26","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1590\/S1806-37132015000000040","article-title":"Sarcopenia in COPD: relationship with COPD severity and prognosis","volume":"41","author":"Costa","year":"2015","journal-title":"J Bras Pneumol"},{"key":"2026090704551284000_12.5.01632-2025.27","doi-asserted-by":"publisher","DOI":"10.1007\/BF02982704"},{"key":"2026090704551284000_12.5.01632-2025.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2011.01.002"},{"key":"2026090704551284000_12.5.01632-2025.29","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2012.07.017"},{"key":"2026090704551284000_12.5.01632-2025.30","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afy169"},{"key":"2026090704551284000_12.5.01632-2025.31","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0049-2019"},{"key":"2026090704551284000_12.5.01632-2025.32","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1002\/jcsm.12600","article-title":"Diagnosis, prevalence, and clinical impact of sarcopenia in COPD: a systematic review and meta-analysis","volume":"11","author":"Sep\u00falveda-Loyola","year":"2020","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"2026090704551284000_12.5.01632-2025.33","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00070914"},{"key":"2026090704551284000_12.5.01632-2025.34","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/j.clnu.2023.12.010","article-title":"The effect of body compartments on lung function in childhood and adolescence","volume":"43","author":"Ofenheimer","year":"2024","journal-title":"Clin Nutr"},{"key":"2026090704551284000_12.5.01632-2025.35","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.04.00014304"},{"key":"2026090704551284000_12.5.01632-2025.36","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00080312"},{"key":"2026090704551284000_12.5.01632-2025.37","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00354-2020"},{"key":"2026090704551284000_12.5.01632-2025.38","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1186\/s12931-022-02109-3","article-title":"Sarcopenia is associated with cardiovascular risk in men with COPD, independent of adiposity","volume":"23","author":"Leem","year":"2022","journal-title":"Respir Res"},{"key":"2026090704551284000_12.5.01632-2025.39","first-page":"3","article-title":"Sarcopenia in COPD patients: prevalence, patients\u2019 characteristics and predictive factors","volume":"34","author":"Poberezhets","year":"2021","journal-title":"Pneumon"},{"key":"2026090704551284000_12.5.01632-2025.40","first-page":"9762","article-title":"Sarcopenia and its clinical correlation in elderly chronic obstructive pulmonary disease: a prospective cohort study","volume":"27","author":"Wu","year":"2023","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"2026090704551284000_12.5.01632-2025.41","doi-asserted-by":"crossref","first-page":"295","DOI":"10.12873\/441sepulveda","article-title":"Impact of pre-sarcopenia and sarcopenia on biological and functional outcomes in individuals with chronic obstructive pulmonary disease: a cross-sectional study","volume":"44","author":"Sepulveda-Loyola","year":"2024","journal-title":"Nutr Cl\u00edn Diet Hosp"},{"key":"2026090704551284000_12.5.01632-2025.42","first-page":"1628","article-title":"Long-term clinical outcomes of patients with chronic obstructive pulmonary disease with sarcopenia","volume":"13","author":"Choi","year":"2023","journal-title":"Life (Basel)"},{"key":"2026090704551284000_12.5.01632-2025.43","first-page":"3399","article-title":"Determinants of COPD stage progression and regression: a Markov transition model analysis of the COPDGene cohort","volume":"20","author":"Sanchez-Romero","year":"2025","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"2026090704551284000_12.5.01632-2025.44","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2021.09.021"},{"key":"2026090704551284000_12.5.01632-2025.45","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1016\/j.arbres.2024.05.033","article-title":"Spirometric transition of at risk individuals and risks for progression to chronic obstructive pulmonary disease in general population","volume":"60","author":"Jo","year":"2024","journal-title":"Arch Bronconeumol"},{"key":"2026090704551284000_12.5.01632-2025.46","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S406208"},{"key":"2026090704551284000_12.5.01632-2025.47","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00122-2020"},{"key":"2026090704551284000_12.5.01632-2025.48","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2011-200010"},{"key":"2026090704551284000_12.5.01632-2025.49","doi-asserted-by":"publisher","DOI":"10.1378\/chest.121.2.370"},{"key":"2026090704551284000_12.5.01632-2025.50","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0009-2023"}],"container-title":["ERJ Open Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1183\/23120541.01632-2025","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T11:55:21Z","timestamp":1788782121000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.ersnet.org\/lookup\/doi\/10.1183\/23120541.01632-2025"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,23]]},"references-count":50,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,9,7]]},"published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1183\/23120541.01632-2025"],"URL":"https:\/\/doi.org\/10.1183\/23120541.01632-2025","relation":{},"ISSN":["2312-0541"],"issn-type":[{"value":"2312-0541","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,23]]}}}