Distribution of Bone Mineral Content Is Associated with Body Weight and Exercise Capacity in Patients with Chronic Obstructive Pulmonary Disease

Yamamoto, Yoshihiko; Yoshikawa, Masayuki; Tomoda, Koichi; Fujita, Yukio; Yamauchi, Motoo; Fukuoka, Atsuhiko; Tamaki, Shunsuke; Koyama, Noriko; Kimura, Hiroshi

doi:10.1159/000355095

Cited by 7 publications

(6 citation statements)

References 49 publications

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“…The incidence of low BMD is higher in female athletes in the presence of oligo/amenorrhea or delayed menarche [12]. Furthermore, in sedentary populations such as breast cancer survivors [13] or chronic obstructive pulmonary disease (COPD) patients [14], both body weight and lean mass are positively associated with BMD. While body weight is often used when assessing the relationship between weight loss and BMD, multiple studies have reported lean weight to be a much stronger correlate of BMD than body weight or BMI, while no relationship between fat mass and BMD [8, 15–17] has been found in several studies.…”

Section: Obesity and Bmdmentioning

confidence: 99%

Weight loss and bone mineral density

Hunter

Plaisance

Fisher

2014

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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Purpose of the Review Despite evidence that energy deficit produces multiple physiological and metabolic benefits, clinicians are often reluctant to prescribe weight loss in older individuals or those with low BMD, fearing BMD will be decreased. Confusion exists concerning the effects weight loss has on bone health. Recent Findings Bone density is more closely associated with lean mass than total body mass and fat mass. Although rapid/large weight loss is often associated with loss of bone density, slower/smaller weight loss is much less apt to adversely affect BMD, especially when it is accompanied with high intensity resistance and/or impact loading training. Maintenance of calcium and vitamin D intake seems to positively affect BMD during weight loss. While dual energy X-ray absorptiometry is normally used to evaluate bone density, it may overestimate BMD loss following massive weight loss. Volumetric quantitative computed tomography may be more accurate for tracking bone density changes following large weight loss. Summary Moderate weight loss does not necessarily compromise bone health, especially when exercise training is involved. Training strategies that include heavy resistance training and high impact loading that occur with jump training may be especially productive in maintaining, or even increasing bone density with weight loss.

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Section: Obesity and Bmdmentioning

confidence: 99%

Weight loss and bone mineral density

Hunter

Plaisance

Fisher

2014

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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“…Thus, this index might be used to predict the severity of bone loss in patients with COPD with greater accuracy than the presence of osteoporosis, which is based on the BMD of the femoral neck or lumbar spine. A possible explanation for this association is the connection between body weight and BMC found in several previous studies [9,[25][26][27] . Low body weight might be associated with lower calcium intake, protein malnutrition, immobilization, and corticosteroid administration and it can affect the biomechanical stress placed on bones [26,27] .…”

Section: Resultsmentioning

confidence: 78%

“…Furthermore, body weight is likely to decline to a greater degree than the bone mass in COPD patients [9] , meaning that higher w-BMC is associated with greater severity of airflow limitation. A prior report also showed that there was no significant association between height-adjusted BMC and severity of COPD [25] , which suggests that height is not a suitable as a parameter to examine changes in BMC. In our study, only w-BMC of the trunk was not significantly related with severity of COPD.…”

Section: Resultsmentioning

confidence: 94%

“…This can be explained by the mechanism of BMC preservation in the mechanical stress on the bones like trunk. COPD patients tend to have higher metabolic and ventilatory requirements and dyspnea than non-COPD patients, so the bone mass content in the trunk is inclined to remain stable while the limitations to physical activity, such as walking and standing, in patients with severe COPD leads to less mechanical stress on the bones, resulting in significant changes in the w-BMC of the arms, legs, and overall [25] .…”

Section: Resultsmentioning

confidence: 99%

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The Relationship of Weight-adjusted Bone Mass Content Associated with COPD and Associated Factors

Chindaprasirt¹,

Boonsawat²,

Limpawattana³

et al. 2020

pharmaceutical-sciences

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Chindaprasirt et al.: Bone mass content in COPD The objectives of this study were to determine the distributions of weight-adjusted bone mass content and osteoporosis in chronic obstructive pulmonary disease patients, to examine the prevalence of osteoporosis and osteopenia and to determine factors associated with weight-adjusted bone mass content. A crosssectional study of chronic obstructive pulmonary disease patients at a tertiary-care hospital, Thailand was conducted from May 2015 to December 2016. Baseline characteristics were collected and bone mineral density and weight-adjusted bone mass content were measured using dual-energy X-ray absorptiometry. A total of 107 chronic obstructive pulmonary disease patients were included. The prevalence of osteoporosis and osteopenia were 35.5 and 38.2 %, respectively. The distribution of weight-adjusted bone mass content of arms, legs and whole body was significantly correlated with chronic obstructive pulmonary disease severity (p<0.05), but not with the presence of osteoporosis. Factors associated with weight-adjusted bone mass content of the extremities was the severity of chronic obstructive pulmonary disease (adjusted odds ratios of moderate and severe chronic obstructive pulmonary disease were 1.03 and 1.06), waist circumference (adjusted odds ratio 0.99) and appendicular skeletal mass index (adjusted odds ratio 0.98). Both osteoporosis and osteopenia were present in more than a third of the chronic obstructive pulmonary disease patients. The weight-adjusted bone mass content of arms, legs, extremities and whole body were correlated with the degree of airflow limitation but not the presence of osteoporosis. Factors associated with weight-adjusted bone mass content of the extremities were identified. Weight-adjusted bone mass content could be a good index to indicate the degree of bone loss in chronic obstructive pulmonary disease patients.

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“…Discussion group participants expressed anxiety about their breathing, but were often unable to articulate specific concerns, besides their general understanding of the possibility of respiratory health issues associated with severe cases of OI. Participants were also concerned with exercise and weight maintenance, which can be impacted by decreased pulmonary function [ 12 ]. Since pulmonary function also impacts quality of life (QoL) and daily activities, the participants felt that addressing this concern is essential to providing comprehensive care for the spectrum of OI symptoms [ 13 ].…”

Section: Resultsmentioning

confidence: 99%