Lung Function Impairment, Associating Hyperinflation with Impaired Diffusion Capacity and Transfer Coefficient, Is a Risk Factor for Hip Osteoporosis in Patients with Chronic Obstructive Pulmonary Disease

Abstract

Chronic obstructive pulmonary disease (COPD) is a risk factor for osteoporosis. Our objective is to determine if functional indices associated with emphysema on pulmonary function tests (DLCO—diffusion capacity of the lung for CO-; DLCO/AV—DLCO corrected for alveolar volume- and TLC—total lung capacity), considered alone or together, can identify COPD patients with osteoporosis. Methods: 90 COPD patients underwent dual-energy X-ray absorptiometry (DEXA) and pulmonary function tests. Results: 26% of the COPD patients were osteoporotic. In univariate analysis, each functional parameter associated with emphysema, analyzed separately, was not associated with osteoporosis. In contrast, patients with hyperinflation associated with impaired diffusion capacity and transfer coefficient, defined by the association of the three functional indices (DLCO < 70%, DLCO/AV < 80% and CPT > 115%), had significantly more osteoporosis at the total hip (OR: 5.9, CI: 1.5–23.8, p = 0.013). In multivariate analysis, this phenotype was confirmed as an independent factor associated with hip osteoporosis. In contrast, COPD airway obstruction severity, based on FEV1 (%), was not associated with osteoporosis. A lower BMI, female gender and age were also identified as osteoporosis risk factors. Conclusions: COPD patients with hyperinflation associated with impaired diffusion capacity and transfer coefficient are at higher risk for osteoporosis. Pulmonary function tests associated with emphysema detection can help to identify COPD patients with osteoporosis, in addition to the classical risk factors.

Association between chronic obstructive pulmonary disease and bone mineral density: a Mendelian randomization analysis

“…To ascertain the robustness of our ndings, we employed a substantial dataset of osteoporosis information sourced from the FinnGen consortium to corroborate our results, thereby bolstering the credibility of the study. However, several prior studies have documented a correlation between COPD and BMD, which stands in stark contrast to the ndings of our study [15,[32][33][34] . The most notable study in this eld is a comprehensive systematic review and meta-analysis conducted by Ahmad Naoras Bitar et al [15] .…”

Osteoporosis and major fragility fractures (MOF) in sarcoidosis patients: association with disease severity

“…A recent review has reported that severe clinical and personal consequences may arise in the aftermath of VFs, including back pain, physical functional limitations and a poorer physical health-related QoL [33] , is an independent risk factor for hip osteoporosis. [35] The severity of sarcoidosis has been suggested as a potential risk factor for the development of osteoporosis and major fragility fractures (MOF). In fact, we have found that patients with more severe sarcoidosis, as indicated by lung involvement, multiorgan involvement, or higher disease activity, may be at a higher risk of developing osteoporosis and experiencing MOF.…”