Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.
Chin Med J (Engl). 2009 Dec 20;122(24):2939-44.
BACKGROUND: The body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index was shown at predicting the risk of death, exacerbation and disease severity among patients with COPD, but few studies verified relationship between BODE index and health related quality of life (HRQoL) among Chinese COPD patients. The objective of this study was to evaluate the relationship between BODE index and HRQoL in cross-sectional and longitudinal association analyses. METHODS: A multi-center prospective cohort study was initially conducted in 491 stable COPD patients in Beijing, China. Health status (HRQoL) was assessed by St. George's Respiratory Questionnaire (SGRQ); the BODE index was calculated for each patient; dyspnea was assessed using the 5-grade Medical Research Council dyspnea scale. Other measurements included socio-demographic, body mass index (BMI), lung function test and 6-minute-walk test (6MWT). Patients were then followed monthly for 12 months. RESULTS: Only 450 patients completed the 1-year follow up and were enrolled in our present analyses. Mean age was (65.2 +/- 10.6) years, men 309 (68.7%). The BODE index was categorized into 4 subgroups: 0 - 2, 3 - 4, 5 - 6 and 7 - 10. At baseline BODE index was gradually increased with baseline total SGRQ and SGRQ subscales (P trend < 0.001). For individual components of BODE index, with the decrease of airflow limitation, and 6MWD, and with the increase of Medical Research Council (MRC) dyspnea grade, total SGRQ and SGRQ subscales were increased correspondingly, P trend < 0.05, respectively. Similar association patterns were found between baseline BODE index and its individual components and mean SGRQ scores at the end of 1-year follow up. By multiple linear regression analyses, baseline BODE index was not only significantly associated with SGRQ score at baseline but also with SGRQ score at the end of 1-year follow up after adjustment for age, male, current smoking, betas being 0.434 and 0.378, respectively. CONCLUSIONS: BODE index is associated with SGRQ score cross-sectionally and longitudinally among stable COPD patients. BODE index might have potential to be used as a sensitive tool to assess the status of quality of life and to monitor disease progression among stable COPD patients.
背景：体重指数、气流阻塞、呼吸困难和运动能力（BODE）指数已被证明可预测 COPD 患者的死亡风险、恶化和疾病严重程度，但很少有研究验证 BODE 指数与中国 COPD 患者的健康相关生活质量（HRQoL）之间的关系。本研究的目的是通过横断面和纵向关联分析评估 BODE 指数与 HRQoL 之间的关系。
方法：本研究采用多中心前瞻性队列研究，纳入 491 例稳定期 COPD 患者，在北京进行。健康状况（HRQoL）采用圣乔治呼吸问卷（SGRQ）评估；为每位患者计算 BODE 指数；呼吸困难采用 5 级医学研究理事会呼吸困难量表评估。其他测量包括社会人口统计学、体重指数（BMI）、肺功能检查和 6 分钟步行试验（6MWT）。随后，患者每月随访 12 个月。
结果：只有 450 例患者完成了 1 年随访并纳入本研究。平均年龄（65.2±10.6）岁，男性 309 例（68.7%）。BODE 指数分为 4 组：0-2、3-4、5-6 和 7-10。在基线时，BODE 指数随基线总 SGRQ 和 SGRQ 亚量表逐渐升高（P 趋势<0.001）。对于 BODE 指数的个体成分，随着气流受限和 6MWD 的降低，以及医学研究理事会（MRC）呼吸困难等级的增加，总 SGRQ 和 SGRQ 亚量表相应增加，P 趋势<0.05。在基线时，BODE 指数及其个体成分与 1 年随访结束时的平均 SGRQ 评分之间也存在相似的关联模式。通过多元线性回归分析，在调整年龄、性别、当前吸烟后，基线 BODE 指数不仅与基线 SGRQ 评分显著相关，而且与 1 年随访结束时的 SGRQ 评分显著相关，分别为 0.434 和 0.378。
结论：在稳定期 COPD 患者中，BODE 指数与 SGRQ 评分呈横断面和纵向相关。BODE 指数可能具有作为评估稳定期 COPD 患者生活质量状况和监测疾病进展的敏感工具的潜力。
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