Correlates of osteoporosis in chronic obstructive pulmonary disease: An underestimated systemic component

Graat‐Verboom, Lidwien; Spruit, Martijn A.; Borne, Ben E. E. M. van den; Smeenk, Frank W.J.M.; Martens, Elisabeth J.; Lunde, Ragnar; Wouters, Emiel F.M.

doi:10.1016/j.rmed.2009.02.014

Cited by 106 publications

(90 citation statements)

References 52 publications

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“…COPD and bronchial asthma are risk factors for osteoporosis; these patients often display a loss of significant amounts of both cortical and trabecular bone [1][2][3][4][5][6][7][8][9]. These patients are also often treated with oral or inhaled glucocorticoids and this contributes to significant additional bone loss.…”

Section: Discussionmentioning

confidence: 99%

“…After at least one practice blow, three FEV 1 and FVC readings were recorded. The highest FEV 1 and FVC values from satisfactory manoeuvres were used in the analyses, which did not necessarily come from the same blow. For FEV 1 , 84.7% of the men and 92.2% of the women had a difference of ≤ 0.15 litres between their two highest readings; for FVC, the corresponding figures were 81.0% for men and 89.7% for women.…”

Section: Study Populationmentioning

confidence: 99%

“…the prevalence of reduced bone density and vertebral fractures in patients with chronic obstructive pulmonary disease (COPD) is high [1][2][3][4]; furthermore case-control studies have confirmed reduced bone mineral density (BMD) in COPD patients compared with controls [5][6], even in those with milder disease [7] while in patients who have osteoporosis and spinal deformities, reduced pulmonary function is related to the severity of osteoporosis [9][10][11] in the same way that the worse the level of lung function in COPD patients, the greater the likelihood of low BMD [12].…”

Section: Introductionmentioning

confidence: 99%

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Is lung function associated with bone mineral density? Results from the Hertfordshire Cohort Study

et al. 2013

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Purpose-There is limited information available regarding the association between lung function and bone mineral density among healthy elderly subjects. We addressed this issue in the Hertfordshire Cohort Study.Methods-985 subjects (496 men and 489 women) aged 60-72 years were recruited from the above cohort. All subjects underwent bone density measurements using dual energy X-ray absorptiometry (DXA), and lung function tests using standardised spirometry. Chronic obstructive pulmonary disease (COPD) was defined as a Forced Expiratory Volume in 1 second (FEV 1) / Forced Vital Capacity (FVC) ratio < lower limit of normal (LLN), calculated using separate equations for men and women.Results-Measures of lung function (FEV 1 , FVC, FEV 1 /FVC) were not associated with bone mineral density at the lumbar spine, femoral neck and total hip in men or women; associations with bone mineral content and bone area were removed by adjustment for body size and lifestyle confounders. In this cohort, there were no associations observed between COPD and any measure of bone mass.Conclusions-There was no association between lung function and bone mass in this community dwelling cohort after adjustment for body size and other confounders.

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Section: Discussionmentioning

confidence: 99%

Section: Study Populationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Is lung function associated with bone mineral density? Results from the Hertfordshire Cohort Study

et al. 2013

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“…Chronic obstructive pulmonary disease (COPD) is a prevalent global disorder (1), associated with high risk of osteoporosis in addition to the high economic burden of the disease medical care (2)(3)(4). In United States of America the third cause of death is COPD (5).…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, about 6-70% of COPD patients affected with osteoporosis according to the severity of illness (2). The strength of the handgrip strength was found to be closely related to body lean mass, percentage of fat, fat mass composition and bone mineral density (15).…”

Section: Introductionmentioning

confidence: 99%

Aerobic exercise training modulates bone mineral status in patients with chronic obstructive pulmonary disease

El-Kader

Al-Jiffri

2016

Electron J Gen Med

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Background:Chronic obstructive pulmonary disease (COPD) appears to be associated with low bone mineral density (BMD) due to long-term use of corticosteroids as a result patients with COPD are at risk for osteoporosis-related fractures and worsening pulmonary function. Objective: The present study aimed to measure the effects of treadmill walking exercises on bone mineral status in patients with COPD. Methods: Sixty patients with moderate COPD of both sexes, their age ranged from 45 to 58 years. Subjects were divided into two equal groups: training group (group A) received aerobic exercise training on treadmill for six months, where the second group (B) was considered as a control group who received no exercise training. The program consisted of three sessions per week for six months. Results:The results of this study indicated a significant increase in BMD of the lumbar spine & the radius and serum calcium & significant reduction in parathyroid hormone in group (A), while these changes were not significant in group (B).Also; there was a significant difference between both groups at the end of the study. Conclusion: Treadmill walking exercise training is an effective treatment policy to improve bone mineral status in patients with COPD.

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Bone attenuation on routine chest CT correlates with bone mineral density on DXA in patients with COPD

Romme

Murchison

Phang

et al. 2012

Journal of Bone and Mineral Research

119

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Chronic obstructive pulmonary disease (COPD), although primarily a disease of the lungs, is associated with extrapulmonary effects such as muscle weakness and osteoporosis. Fractures owing to osteoporosis cause significant morbidity and mortality, particularly in patients with COPD. To prevent osteoporotic fractures, it is important to diagnose osteoporosis in an early stage and to start anti-osteoporotic therapy in at-risk patients. Because routine chest computed tomography (CT) is increasingly used to assess the extent of emphysema and airways disease in patients with COPD, we investigated whether simple attenuation measurement of the thoracic spine on routine chest CT may provide useful information on bone health in patients with COPD. Fifty-eight patients with moderate to very severe COPD were included in our study. The average attenuation of thoracic vertebrae 4, 7, and 10 on chest CT was correlated with the lowest bone mineral density (BMD) of the hip and lumbar spine (L 1 to L 4 ) on dual-energy X-ray absorptiometry (DXA) in patients with COPD. The inter-and intra-observer variabilities of the attenuation measurements were low as shown by Bland-Altman plots. Pearson's correlation coefficient between the average attenuation of the three thoracic vertebrae and the lowest BMD of the hip and lumbar spine was high (r ¼ 0.827, p < 0.001). A receiver-operating characteristic (ROC) analysis of the area under the curve for osteoporosis was 0.969 (p < 0.001), corresponding to an attenuation threshold of 147 Hounsfield Units (HU). In conclusion, our data demonstrated that bone attenuation measured on routine chest CT correlated strongly with BMD assessed on DXA in patients with COPD. Routine chest CT may provide useful information on bone health in patients with COPD. ß

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Correlates of osteoporosis in chronic obstructive pulmonary disease: An underestimated systemic component

Abstract: The majority of COPD patients with osteoporosis entering pulmonary rehabilitation did not receive pharmacological treatment for osteoporosis. Cachectic COPD patients should be screened for osteoporosis, especially when over 55 years of age.

Cited by 106 publications

References 52 publications

Is lung function associated with bone mineral density? Results from the Hertfordshire Cohort Study

Is lung function associated with bone mineral density? Results from the Hertfordshire Cohort Study

Aerobic exercise training modulates bone mineral status in patients with chronic obstructive pulmonary disease

Bone attenuation on routine chest CT correlates with bone mineral density on DXA in patients with COPD

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