Impact of nutritional status in sarcoidosis patients

Impact of nutritional status in sarcoidosis patients

Authors

Keywords:

Sarcoidosis, Nutritional status, Respiratory muscle strength, Fatigue

Abstract

Background and aim: Sarcoidosis is a systemic granulomatous disease of unknown etiology, with fatigue being one of the most common symptoms. The cause is still under investigation. Factors such as reduced lung function, respiratory muscle weakness, physical deconditioning, corticosteroid-induced myopathy may cause fatigue. Nutritional status of patients is becoming increasingly important in respiratory diseases. This study aimed to investigate the effect of nutritional assessment on peripheral and respiratory muscle strength, as well as exercise capacity in sarcoidosis patients.

Methods: This prospective, case-controlled study included 31 sarcoidosis patients not receiving systemic steroid therapy and 24 age- and sex-matched healthy controls. Participants were tested for functional exercise capacity using the 6-minute walk test (6MWT), respiratory muscle strength using maximum inspiratory (MIP) and expiratory pressures (MEP), peripheral muscle strength using handgrip dynamometry and lung function tests. Nutritional status was assessed using the Mini Nutritional Assessment (MNA) questionnaire and body composition analysis by bioelectrical impedance.

Results: Despite similar lung function and respiratory muscle strength, sarcoidosis patients showed significantly lower 6MWT distances compared with controls. Sarcoidosis patients had higher body mass index (BMI) and fat mass, while lean mass, smooth muscle mass, skeletal muscle mass, fluid weight and peripheral muscle strength were similar in the patient group and control group. There was no significant difference in MIP, MEP and expected percentage values in sarcoidosis patients compared to the control group. Positive correlations were observed between MIP, MEP and lean body mass, while fat mass was negatively correlated with peak expiratory flow (PEF).

Conclusions: This study highlights the need for individualized interventions, including lifestyle modifications, nutrition, and physical rehabilitation, in sarcoidosis-related fatigue. In our study, BMI and fat weight were significantly higher in sarcoidosis patients. In light of this, further research is needed to investigate the impact of adiposity-related inflammation on sarcoidosis progression and outcomes.

 

Author Biographies

Şeyma Tunç, Kastamonu University Hospital, Department of Pulmonology, Kastamonu

Dr. Şeyma Tunç completed her medical education at Düzce University and specialized in Pulmonology. She is currently working as a Pulmonology specialist at Kastamonu Training and Research Hospital, Turkey. Her clinical and academic interests particularly focus on sarcoidosis and other respiratory diseases. Dr. Şeyma is an active member of the European Respiratory Society (ERS) and the Turkish Thoracic Society (TTS), where she continues to contribute to professional and educational activities.

Pınar Yıldız, Department of Pulmonology, Düzce University Faculty of Medicine, Türkiye

Associate Prof. Dr. Pınar Yıldız
Department of Pulmonology, Düzce University Faculty of Medicine, Türkiye.
Her research interests focus primarily on interstitial lung diseases.

Mehmet Ali Sungur, Department of Biostatistics, Düzce University Faculty of Medicine, Türkiye

Associate Prof. Dr. Mehmet Ali Sungur
He is a faculty member at the Department of Biostatistics, Düzce University Faculty of Medicine. He completed his undergraduate degree in Biology and obtained his master's and doctoral degrees in Biostatistics.

References

1. Musellim B, Kumbasar OO, Ongen G, et al. Epidemiological features of Turkish patients with sarcoidosis. Respir Med 2009 Jun;103(6):907–12.

2. Valeyre D, Prasse A, Nunes H, Uzunhan Y, Brillet PY, Müller-Quernheim J. Sarcoidosis. The Lancet 2014 Mar 29;383(9923):1155–67.

3. Spruit MA, Thomeer MJ, Gosselink R, et al. Skeletal muscle weakness in patients with sarcoidosis and its relationship with exercise intolerance and reduced health status. Thorax 2005 Jan 1;60(1):32–8.

4. Kabitz HJ, Lang F, Walterspacher S, Sorichter S, Müller-Quernheim J, Windisch W. Impact of impaired inspiratory muscle strength on dyspnea and walking capacity in sarcoidosis. Chest 2006 ;130(5):1496–502.

5. Baughman RP, Sparkman BK, Lower EE. Six-minute walk test and health status assessment in sarcoidosis. Chest 2007 Jul 1;132(1):207–13.

6. Alhamad– EH. The six-minute walk test in patients with pulmonary sarcoidosis. Ann Thorac Med 2009 Jul 1;4(2):604.

7. Wirnsberger RM, Drent M, Hekelaar N, et al. Relationship between respiratory muscle function and quality of life in sarcoidosis. Eur Respir J 1997 Jul ;10(7):1450–5.

8. Baydur A, Alsalek M, Louie SG, Sharma OP. Respiratory muscle strength, lung function, and dyspnea in patients with sarcoidosis. Chest 2001;120(1):102–

9. Tutuş N, Pehlivan E. Sarkoidozda Pulmoner Rehabilitasyon. Sağlık Profesyonelleri Araştırma Dergisi 2023 Oct 30 ;5(3):189–97.

10. Marcellis RGJ, Lenssen AF, Elfferich MDP, et al. Exercise capacity, muscle strength and fatigue in sarcoidosis. Eur Respir J 2011 Sep ;38(3):628–34.

11. Walsh SL, Wells AU, Sverzellati N, et al. An integrated clinicoradiological staging system for pulmonary sarcoidosis: a case-cohort study. Lancet Respir Med 2014 Feb;2(2):123-30. doi: 10.1016/S2213-2600(13)70276-5.

12. Marcellis RGJ, Lenssen AF, De Vries J, Drent M. Reduced muscle strength, exercise intolerance and disabling symptoms in sarcoidosis. Curr Opin Pulm Med 2013 Sep;19(5):524–30.

13. Brancaleone P, Perez T, Robin S, Neviere R, Wallaert B. Clinical impact of inspiratory muscle impairment in sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2004 Oct 1 ;21(3):219–27.

14. Pescaru C, Frandes M, Marc M, Traila D, Pescaru A, Oancea C. Physical Activity and Respiratory Muscle Strength in Patients with Sarcoidosis: An Observational Study. Int J Gen Med 2022 Jan 6;15:291–7.

15. Kanjrawi AA, Mathers L, Webster S, Corte TJ, Carey S. Nutritional status and quality of life in interstitial lung disease: a prospective cohort study. BMC Pulm Med 2021 Dec 1;21(1):1–9.

16. Peterson SJ, Park J, Zellner HK, et al. Relationship Between Respiratory Muscle Strength, Handgrip Strength, and Muscle Mass in Hospitalized Patients. Journal of Parenteral and Enteral Nutrition 2020 Jul 1;44(5):831–6.

17. Harpsøe MC, Basit S, Andersson M, et al. Body mass index and risk of autoimmune diseases: a study within the Danish National Birth Cohort. Int J Epidemiol 2014 Jun 1;43(3):843–55.

18. Dumas O, Boggs KM, Cozier YC, Stampfer MJ, Camargo CA. Prospective study of body mass index and risk of sarcoidosis in US women. Eur Respir J 2017 Oct 1;50(4).

19. Yıldız Gülhan P, Güleç Balbay E, Erçelik M, Yıldız Ş, Yılmaz MA. Is sarcoidosis related to metabolic syndrome and insulin resistance? The Aging Male 2020 Jan 2 ;23(1):53–8.

20. Bilici Salman R, Haznedaroğlu Ş. Sistemik lupus eritematozusda prognostik nutrisyonel indeksin hastalık aktivitesi ile olan ilişkisinin araştırılması: Tek merkez deneyimi. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi 2021 Aug 31 ;54(2):181–7.

21. Isik AC, Kavas M, Boga S, Karagöz A, Kocabay G, Sen N. Are inflammatory and malnutrition markers associated with metabolic syndrome in patients with sarcoidosis? Rev Assoc Med Bras 2021 ;67(12):1779–84.

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Published

30-09-2025

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Section

Original Articles: Clinical Research

How to Cite

1.
Tunç Şeyma, Yıldız P, Sungur MA. Impact of nutritional status in sarcoidosis patients. Sarcoidosis Vasc Diffuse Lung Dis [Internet]. 2025 Sep. 30 [cited 2025 Nov. 11];42(3):16968. Available from: https://mail.mattioli1885journals.com/index.php/sarcoidosis/article/view/16968