The modified Medical Research Council scale for the assessment of dyspnea in daily living in obesity: a pilot study

BMC Pulmonary Medicine

Gaëtan Deslee²  François Lebargy²  Sandra Dury²  Jeanne-Marie Perotin²  Julie Nardi²  Eric Bertin¹  Coralie Barbe³  Claire Launois² 

[1] Service d’Endocrinologie-Diabétologie-Nutrition, Hôpital Robert Debré, CHU de Reims, Reims, France;Service des Maladies Respiratoires, INSERM UMRS 903, Hôpital Maison Blanche, CHU de Reims, 45 rue Cognacq Jay 51092, Reims, Cedex, France;Unité d'Aide Méthodologique, Pôle Recherche et Innovations, Hôpital Robert Debré, CHU de Reims, Reims, France

关键词: Lung function;    Six-minute walk test;    Modified Medical Research Council scale;    Obesity;    Dyspnea;   

Others  :  1136348
DOI  :  10.1186/1471-2466-12-61

 received in 2012-04-06, accepted in 2012-09-22,  发布年份 2012

【 摘 要 】

Background

Dyspnea is very frequent in obese subjects. However, its assessment is complex in clinical practice. The modified Medical Research Council scale (mMRC scale) is largely used in the assessment of dyspnea in chronic respiratory diseases, but has not been validated in obesity. The objectives of this study were to evaluate the use of the mMRC scale in the assessment of dyspnea in obese subjects and to analyze its relationships with the 6-minute walk test (6MWT), lung function and biological parameters.

Methods

Forty-five obese subjects (17 M/28 F, BMI: 43 ± 9 kg/m²) were included in this pilot study. Dyspnea in daily living was evaluated by the mMRC scale and exertional dyspnea was evaluated by the Borg scale after 6MWT. Pulmonary function tests included spirometry, plethysmography, diffusing capacity of carbon monoxide and arterial blood gases. Fasting blood glucose, total cholesterol, triglyceride, N-terminal pro brain natriuretic peptide, C-reactive protein and hemoglobin levels were analyzed.

Results

Eighty-four percent of patients had a mMRC ≥ 1 and 40% a mMRC ≥ 2. Compared to subjects with no dyspnea (mMRC = 0), a mMRC ≥ 1 was associated with a higher BMI (44 ± 9 vs 36 ± 5 kg/m², p = 0.01), and a lower expiratory reserve volume (ERV) (50 ± 31 vs 91 ± 32%, p = 0.004), forced expiratory volume in one second (FEV₁) (86 ± 17 vs 101 ± 16%, p = 0.04) and distance covered in 6MWT (401 ± 107 vs 524 ± 72 m, p = 0.007). A mMRC ≥ 2 was associated with a higher Borg score after the 6MWT (4.7 ± 2.5 vs 6.5 ± 1.5, p < 0.05).

Conclusion

This study confirms that dyspnea is very frequent in obese subjects. The differences between the “dyspneic” and the “non dyspneic” groups assessed by the mMRC scale for BMI, ERV, FEV₁ and distance covered in 6MWT suggests that the mMRC scale might be an useful and easy-to-use tool to assess dyspnea in daily living in obese subjects.

【 授权许可】

   
2012 Launois et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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