Evidence map›Paper›PMID 42276842›Full record

Observational studyRespirology (Carlton, Vic.)2026

Association of Airway Mucus Plugs and Physical Activity, Exercise Tolerance, Sarcopenia, and Frailty in Patients With COPD and Pre-COPD.

Yusuke Shiraishi, Naoya Tanabe, Tomoki Maetani, Yusuke Hayashi, Yohei Oshima, Yuji Yoshioka, Ryota Hamada, Ryo Sakamoto, Satoru Terada, Atsuyasu Sato and 2 more

Abstract readObservational Study
In one paragraph

Observational study in Respirology (Carlton, Vic.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Yusuke ShiraishiDepartment of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.ORCID https://orcid.org/0000-0003-4978-5673
Naoya TanabeDepartment of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.ORCID https://orcid.org/0000-0002-7481-0212
Tomoki MaetaniDepartment of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Yusuke HayashiDepartment of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Yohei OshimaRehabilitation Unit, Kyoto University Hospital, Kyoto, Japan.ORCID https://orcid.org/0000-0003-0680-4045
Yuji YoshiokaRehabilitation Unit, Kyoto University Hospital, Kyoto, Japan.
Ryota HamadaRehabilitation Unit, Kyoto University Hospital, Kyoto, Japan.
Ryo SakamotoDepartment of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.ORCID https://orcid.org/0000-0003-1310-9403
Satoru TeradaDepartment of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Atsuyasu SatoDepartment of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Susumu SatoDepartment of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.ORCID https://orcid.org/0000-0002-9626-1090
Toyohiro HiraiDepartment of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.ORCID https://orcid.org/0000-0002-7431-9044

Funding

Japanese Respiratory FoundationJapan Society for the Promotion of Science 22K08233Japan Society for the Promotion of Science 25K11479
6 · The paper itself

Abstract

BACKGROUND AND

objectiveAirway mucus plugs on computed tomography (CT) are an imaging biomarker of chronic obstructive pulmonary disease (COPD) associated with airflow limitation, respiratory symptoms, and poor prognosis. However, clinical phenotypes relevant to mucus plugs, including sarcopenia and frailty, are not fully elucidated. This study aimed to investigate the association between mucus plugs, sarcopenia, and frailty using a prospective observational COPD-enriched smoker cohort.

methodsIn this cross-sectional analysis, patients with COPD and pre-COPD were classified into no-, low-, and high-mucus groups according to mucus scores on CT. The risks of frailty and sarcopenia, and relevant clinical, functional, and imaging factors including 6-min walk distance (6MWD), physical activity, body compositions via bioelectrical impedance analysis (BIA), and intra- and extrapulmonary CT indices were compared between groups.

resultsAmong 175 patients (142 COPD, 33 pre-COPD, and n = 106, 48, and 21 in the no-, low-, and high-mucus groups), the high-mucus group was associated with increased odds ratio for sarcopenia independent of age, sex, height, smoking, and forced expiratory volume in 1 s, or emphysema and wall area percentage (WA%). The high-mucus group demonstrated increased airtrapping and WA%, reduced total airway count, and decreased muscle and fat mass (assessed by both BIA and CT), while emphysema was not different. Furthermore, 6MWD deteriorated in the high-mucus group independent of age, sex, height, and smoking, whereas physical activity did not differ.

conclusionIn patients with COPD and pre-COPD, mucus plugs are associated with reduced muscle and fat mass and a heightened sarcopenia risk.

Indexed as

ExerciseExercise ToleranceFrailtyMucusPulmonary Disease, Chronic ObstructiveSarcopeniaAgedBody CompositionCross-Sectional StudiesFemaleForced Expiratory VolumeHumansMaleMiddle AgedProspective StudiesTomography, X-Ray ComputedCOPDfrailtymucus plugssarcopenia

Identifiers

PMID42276842
PMCPMC13535758

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.