Indian Journal of Respiratory Care

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VOLUME 11 , ISSUE 3 ( July-September, 2022 ) > List of Articles

Original Article

Anthropometry and BODE Index in Stable Chronic Obstructive Pulmonary Disease Patients and its Correlation with Disease Severity and Health-Related Quality of Life

Pragya Sharma, Farhanulla K. M. Basha, Bhumika Vaishnav, Tushar Tonde, Nirali Thakkar, Kartheek Minna

Keywords : Anthropometry, body mass index, chronic obstructive, pulmonary disease, quality of life

Citation Information : Sharma P, Basha FK, Vaishnav B, Tonde T, Thakkar N, Minna K. Anthropometry and BODE Index in Stable Chronic Obstructive Pulmonary Disease Patients and its Correlation with Disease Severity and Health-Related Quality of Life. Indian J Respir Care 2022; 11 (3):240-245.

DOI: 10.4103/ijrc.ijrc_32_22

License: CC BY-NC-SA 4.0

Published Online: 01-12-2022

Copyright Statement:  Copyright © 2022; Indian Journal of Respiratory Care.


Introduction: Patients with chronic obstructive pulmonary disease (COPD) are often malnourished with resultant poor health.related quality of life (HRQoL). This study aimed to determine various anthropometric indices and the BODE index in stable COPD patients and correlate them with HRQoL using the St. George's Respiratory Questionnaire (SGRQ). Materials and Methods: A cross.sectional, observational study was done between August 2019 and September 2021 at a tertiary care hospital in 100 stable COPD patients. Results: Fifty-four males and 46 females with a mean age of 53± 11 years. Average body mass index (BMI) was 21.27 ± 2.62 kg/m2. The mean BODE index of the study participants was 4.37 ± 1.78. The anthropometric indices - triceps/scapular skin fold thickness, ratio, and mid.upper.arm circumference did not correlate significantly with worsening Global Initiative for COPD (GOLD) stages (one.way analysis of variance [ANOVA] P > 0.05). There was a correlation between decreasing BMI and the worsening GOLD stage (one.way ANOVA P < 0.05). The anthropometric indices did not correlate with the BODE Index (Pearson Correlation coefficient P > 0.05). On linear regression analysis, higher GOLD stage, higher Modified Medical Research Council grade, and lower BMI correlated with higher SGRQ score. Conclusion: Stable COPD patients with low BMI and poor BODE index had poor HRQoL. Other anthropometric indices did not correlate with HRQoL.

  1. Global Initiative for Chronic Obstructive Lung Disease – Global Initiative for Chronic Obstructive Lung Disease – GOLD. Global Initiative for Chronic Obstructive Lung Disease – GOLD; 2022. Available from: [Last accessed on 2021 Nov 24].
  2. Pauwels RA, Buist AS, Calverley PM, Jenkins CR, Hurd SS; GOLD Scientific Committee. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. Am J Respir Crit Care Med 2001;163:1256-76.
  3. Jagmohan SV, Kumari KA, Sreekala S. A cross sectional study to assess the nutritional status of Chronic Obstructive Pulmonary Disease Patients. Int J Med Res Rev 2016;4:1566-70.
  4. Verma A, Gudi N, Yadav UN, Roy MP, Mahmood A, Nagaraja R, et al. Prevalence of COPD among population above 30 years in India: A systematic review and meta-analysis. J Glob Health 2021;11:04038.
  5. Cote CG, Pinto-Plata VM, Marin JM, Nekach H, Dordelly LJ, Celli BR. The modified BODE index: Validation with mortality in COPD. Eur Respir J 2008;32:1269-74.
  6. St. George's Respiratory Questionnaire (SGRQ); 2022. Avilable form: [Last accessed on 2021 Nov 24].
  7. Blanco I, Diego I, Bueno P, Fernández E, Casas-Maldonado F, Esquinas C, et al. Geographical distribution of COPD prevalence in Europe, estimated by an inverse distance weighting interpolation technique. Int J Chron Obstruct Pulmon Dis 2018;13:57-67.
  8. Chaurasia A, Tiwari A, Jalal J. Effect of BMI & WC on severity of COPD patients. Int J Health Clin Res 2021;4:72-5.
  9. Raizada N, Daga M, Kumar N, Mathur S. Nutritional intervention in stable COPD patients and its effect on anthropometry, pulmonary function, and health-related quality of life (HRQL). J Indian Acad Clin Med 2014;15:100-5.
  10. Lisspers K, Larsson K, Janson C, Ställberg B, Tsiligianni I, Gutzwiller FS, et al. Gender differences among Swedish COPD patients: Results from the ARCTIC, a real-world retrospective cohort study. NPJ Prim Care Respir Med 2019;29:45.
  11. Orozco-Levi M, Garcia-Aymerich J, Villar J, Ramírez-Sarmiento A, Antó JM, Gea J. Wood smoke exposure and risk of chronic obstructive pulmonary disease. Eur Respir J 2006;27:542-6.
  12. Torres-Duque C, Maldonado D, Pérez-Padilla R, Ezzati M, Viegi G; Forum of International Respiratory Studies (FIRS) Task Force on Health Effects of Biomass Exposure. Biomass fuels and respiratory diseases: A review of the evidence. Proc Am Thorac Soc 2008;5:577-90.
  13. KalagoudaMahishale V, Angadi N, Metgudmath V, Lolly M, Eti A, Khan S. The prevalence of chronic obstructive pulmonary disease and the determinants of underdiagnosis in women exposed to biomass fuel in India – A cross section study. Chonnam Med J 2016;52:117-22.
  14. Aryal S, Diaz-Guzman E, Mannino DM. COPD and gender differences: An update. Transl Res 2013;162:208-18.
  15. Horner A, Burghuber OC, Hartl S, Studnicka M, Merkle M, Olschewski H, et al. Quality of life and limitations in daily life of stable COPD outpatients in a real-world setting in Austria – Results from the CLARA project. Int J Chron Obstruct Pulmon Dis 2020;15:1655-63.
  16. O'Donnell DE, Milne KM, James MD, de Torres JP, Neder JA. Dyspnea in COPD: New mechanistic insights and management implications. Adv Ther 2020;37:41-60.
  17. Smith J, Woodcock A. Cough and its importance in COPD. Int J Chron Obstruct Pulmon Dis 2006;1:305-14.
  18. Calverley PM. Cough in chronic obstructive pulmonary disease: Is it important and what are the effects of treatment? Cough 2013;9:17.
  19. Marin JM, Carrizo SJ, Casanova C, Martinez-Camblor P, Soriano JB, Agusti AG, et al. Prediction of risk of COPD exacerbations by the BODE index. Respir Med 2009;103:373-8.
  20. Funk GC, Kirchheiner K, Burghuber OC, Hartl S. BODE index versus GOLD classification for explaining anxious and depressive symptoms in patients with COPD – A cross-sectional study. Respir Res 2009;10:1.
  21. Fryar CD, Gu Q, Ogden CL, Flegal KM. Anthropometric Reference Data for Children and Adults: United States, 2011-2014. Vital Health Stat 3 Anal Stud 2016;(39):1-46.
  22. Kumar A, Gaur JK, Agnihotri SP. Microalbuminuria and serum CRP: Potential biomarkers for cardiovascular risk among stable COPD. J Assoc Chest Phys 2021;9:65.
  23. Londhe J, Mudliar K, Powar K, Dhadge N, Gaikwad S, Modi M, et al. Direct and Indirect Costs of COPD Treatment in Pune city, India; 2019.
  24. Challa SR, Shaik AR, Musku MR. A study on evaluation of nutritional status in patients with chronic obstructive pulmonary disease. JEMDS 2020;9:3828-32.
  25. Sami R, Sadegh R, Esmailzadehha N, Mortazian S, Nazem M, Zohal M. Association of anthropometric indexes with disease severity in male patients with chronic obstructive pulmonary disease in Qazvin, Iran. Am J Mens Health 2018;12:1023-8.
  26. Charbek E, Espiritu JR, Nayak R, Morley JE. Editorial: Frailty, comorbidity, and COPD. J Nutr Health Aging 2018;22:876-9.
  27. Yallamraju SR, Mehrotra R, Sinha A, Gattumeedhi SR, Gupta A, Khadse SV. Use of mid upper arm circumference for evaluation of nutritional status of OSMF patients. J Int Soc Prev Community Dent 2014;4:S122-5.
  28. Hronek M, Kovarik M, Aimova P, Koblizek V, Pavlikova L, Salajka F, et al. Skinfold anthropometry – The accurate method for fat free mass measurement in COPD. COPD 2013;10:597-603.
  29. Ferreira IM, Brooks D, Lacasse Y, Goldstein RS. Nutritional support for individuals with COPD: A meta-analysis. Chest 2000;117:672-8.
  30. Hajiro T, Nishimura K, Tsukino M, Ikeda A, Koyama H, Izumi T. Analysis of clinical methods used to evaluate dyspnea in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1998;158:1185-9.
  31. Sarkar SK, Basuthakur S, Das SK, Das A, Das S, Choudhury S, et al. Evaluation of correlation of BODE index with health-related quality of life among patients with stable COPD attending a tertiary care hospital. Lung India 2015;32:24-8.
  32. Medinas-Amorós M, Alorda C, Renom F, Rubí M, Centeno J, Ferrer V, et al. Quality of life in patients with chronic obstructive pulmonary disease: The predictive validity of the BODE index. Chron Respir Dis 2008;5:7-11.
  33. Sarioglu N, Alpaydin AO, Coskun AS, Celik P, Ozyurt BC, Yorgancioglu A. Relationship between BODE index, quality of life and inflammatory cytokines in COPD patients. Multidiscip Respir Med 2010;5:84-91.
  34. Tsiligianni I, Kocks J, Tzanakis N, Siafakas N, van der Molen T. Factors that influence disease-specific quality of life or health status in patients with COPD: A review and meta-analysis of Pearson correlations. Prim Care Respir J 2011;20:257-68.
  35. Katsura H, Yamada K, Kida K. Both generic and disease specific health-related quality of life are deteriorated in patients with underweight COPD. Respir Med 2005;99:624-30.
  36. Nonato NL, Díaz O, Nascimento OA, Dreyse J, Jardim JR, Lisboa C. Behavior of quality of life (SGRQ) in COPD patients according to BODE scores. Arch Bronconeumol 2015;51:315-21.
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