Introduction: The various distribution of fat mass (FM) and lean mass (LM) during COPD development is not yet researched.

Material and methods: 82 male patients (40–67 years) with acute exacerbation of COPD and 19 comparable healthy males (the control group) were examined by dual-energy X-ray absorptiometry. The patients were divided into 3 groups according to COPD severity: 1^st — 19 (GOLD I stage); 2^nd — 43 (GOLD II) and 3^rd — 20 (GOLD III).

Results: The patients of 3^rd group had lower indices of FM, LM, bone mineral component (BMC) vs. the control and 1^st, 2^nd groups. A significant increase in FM share was noted in android and gynoid regions, trunk, legs and arms in 2^nd groups vs. the control with the decline of these parameters in the 3rd group below the control level. A greater proportion of FM in 1^st and 2^nd groups was distributed in android and trunk regions vs. the control. TNF-a and leptin levels were significantly increased by 12%, 15% 17% and by 18%, 75%, 79% respectively in 1^st, 2^nd, 3^rd groups vs. the control, while free testosterone level was lower in these groups vs. the control (by 28%, 30% and 47% respectively; p < 0,05).

Conclusions: Body mass index (BMI) was within the control range in mild-moderate COPD patients in spite of LM, FM and BMC changes. The level of LM and BMC was decreased during COPD progression, while FM was increased in mild-moderate COPD and then it was decreased in severe COPD.