The relationship between anthropometric indicators and walking distance in patients with chronic obstructive pulmonary disease

Abstract

Shu-Chuan Ho,1,* Min-Fang Hsu,2,3,* Han-Pin Kuo,4 Jiun-Yi Wang,2 Li-Fei Chen,4 Kang-Yun Lee,5,6 Hsiao-Chi Chuang11School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, 2Department of Healthcare Administration, Asia University, Wufeng, Taichung, 3Department of Nursing, Kang-Ning Junior College of Medical Care and Management, Taipei, 4Department of Thoracic Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, 5Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, 6Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan*These authors contributed equally to this workBackground: Exercise intolerance is a major issue affecting many people with COPD. Six-minute walking distance (6MWD) is a widely used indicator of exercise capacity in patients with COPD. The process is strenuous and time-consuming, especially for patients who have muscle wasting. Anthropometric indicators that reflect body lean mass, such as body mass index (BMI), mid-arm circumference (MAC), and calf circumference (CC), may have value in predicting exercise intolerance.Purpose: This study attempted to determine the abilities of simple anthropometric indicators including BMI, MAC, and CC in reflecting the exercise intolerance of COPD patients.Methods: We recruited 136 nonhospitalized ambulatory COPD patients without acute conditions from a general hospital in Taiwan. Each subject’s BMI, MAC, and CC were measured, and they were examined with pulmonary function tests and a 6-minute walk test.Results: Among the three anthropometric indicators examined, CC showed the strongest correlation with the 6MWD, followed by MAC and BMI. CC was also strongly associated with functional capacity, followed by MAC, according to the receiver operating characteristic curves. CC and MAC, but not BMI, were significantly associated with exercise intolerance according to logistic regression models that controlled for potential confounders.Conclusion: Among the three variables examined, CC and walking distance may have the strongest association in COPD patients. CC may have value in serving as an adjunct to 6MWD in evaluating exercise intolerance of patients with COPD.Keywords: 6-minute walk distance, BMI, calf circumference, COPD, mid-arm circumference