Predictors of Osteoporosis and Vertebral Fractures in Patients Presenting with Moderate-to-Severe Chronic Obstructive Lung Disease

Ogura-Tomomatsu, Hiromi; Asano, Koichiro; Tomomatsu, Katsuyoshi; Miyata, Jun; Ohmori, Nao; Kodama, Motohiro; Ueda, Soichiro; Takihara, Takahisa; Tanaka, Kyuto; Kamiishi, Nobufumi; Suzuki, Yuzo; Fukunaga, Koichi; Oguma, Tsuyoshi; Sayama, Koichi; Betsuyaku, Tomoko

doi:10.3109/15412555.2012.667850

Cited by 50 publications

(56 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The prevalence of VFs in our study population (21.6% of the COPD subjects had !1 VF at baseline and 33.5% at 3-year followup) was at the somewhat lower range compared with prevalence of most COPD reports found in literature (mostly 24% to 45%, (23)(24)(25)(26)(27)(28)(29)(30)32) with outliers of 9.0% (15) and 79.4% (31) ). This could probably be explained by the fact that the subjects in this study were not using oral GC at baseline because of study design (subjects using oral GC at baseline were excluded, and only 23 and 47 subjects, respectively, reported oral GC use at 1-year and 3-year follow-up), whereas in most (12% to 86% (15,(25)(26)(27)(29)(30)(31)(32) GC use) but not all (2.2% to 4.5% (23,24,28) GC use) studies, the percentage of subjects using GCs was considerably higher.…”

Section: Comparison To Published Researchmentioning

confidence: 52%

“…This could probably be explained by the fact that the subjects in this study were not using oral GC at baseline because of study design (subjects using oral GC at baseline were excluded, and only 23 and 47 subjects, respectively, reported oral GC use at 1-year and 3-year follow-up), whereas in most (12% to 86% (15,(25)(26)(27)(29)(30)(31)(32) GC use) but not all (2.2% to 4.5% (23,24,28) GC use) studies, the percentage of subjects using GCs was considerably higher.…”

Section: Comparison To Published Researchmentioning

confidence: 80%

“…(12,18,22) The prevalence of radiographic VFs in subjects with COPD as reported in the literature is varying between 9.0% and 79%, (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34) with the prevalence of radiographic VFs in subjects with COPD increasing from 32% to 52% in a 3-year time period. (32) However, the incidence of clinical VFs in subjects with COPD was as low as 1.3/1000 person-years (35) to 6% over 2.6 years (36) and 0.5% to 1.0% within 3 years.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

High Imminent Vertebral Fracture Risk in Subjects With COPD With a Prevalent or Incident Vertebral Fracture

Dort

Geusens

Driessen

et al. 2018

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

Subjects with chronic obstructive pulmonary disease (COPD) have an increased risk of vertebral fractures (VFs); however, VF incidence is largely unknown. Therefore, the aim of our study was to determine the incidence of new and/or worsening VF in subjects with COPD. Smokers and subjects with COPD (GOLD II-IV) from the ECLIPSE study with complete set of chest CT scans (baseline and 1-and 3-year follow-up) to evaluate vertebrae T 1 down to L 1 were included. If a VF was diagnosed on the last scan, detailed VF assessment of the previous scans was performed. VFs were scored according to the method of Genant as mild, moderate, or severe. Main outcome measure was the cumulative incidence of new and/or worsening VF at subject level, within 1 and 3 years. Of 1239 subjects (mean age 61 years, 757 males [61%], 999 subjects with COPD), 253 (20.5%) had !1 prevalent VF. The cumulative incidence of VFs was 10.1% within 1 year and 24.0% within 3 years. After adjustment for age, sex, body mass index (BMI), pack-years, and smoking status, prevalence and incidence were similar between smokers and COPD GOLD stages. Within 1 year, 29.2% of the subjects with a prevalent VF had an incident VF, compared with 5.1% in absence of prevalent VF (hazard ratio [HR] ¼ 5.1; 95% confidence interval [CI] 3.6-7.4) and 58.5% versus 15.0% within 3 years (HR ¼ 3.6; 95% CI 2.9-4.6). The incidence of VF was higher with increasing number and severity of prevalent VFs. Among subjects having an incident VF within the first year, 57.3% had a subsequent VF within the next 2 years. In this study, more than half of the smokers and subjects with COPD with a prevalent VF or an incident VF within the first year sustained a subsequent VF within 3 years. The 3-year risk was even higher in the presence of multiple or severe prevalent VFs.

show abstract

Section: Comparison To Published Researchmentioning

confidence: 52%

Section: Comparison To Published Researchmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

High Imminent Vertebral Fracture Risk in Subjects With COPD With a Prevalent or Incident Vertebral Fracture

Dort

Geusens

Driessen

et al. 2018

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

show abstract

“…Therefore, early identification of high-risk patients is an important step toward increasing treatment rates. However, relying on BMD screening alone is not considered sufficient to detect high-risk patients in a timely and cost-effective manner (Ogura-Tomomatsu et al, 2012; Schuit et al, 2004). …”

Section: Introductionmentioning

confidence: 99%

Risk and clinical predictors of osteoporotic fracture in East Asian patients with chronic obstructive pulmonary disease: a population-based cohort study

Lee

Kok

Chou

et al. 2016

PeerJ

View full text Add to dashboard Cite

IntroductionOsteoporosis is becoming an impending epidemic in the Asia-Pacific region. The association between risk of osteoporotic fracture (OTPF) and chronic obstructive pulmonary disease (COPD) in East Asian patients is yet to be fully examined. We conducted a nationwide population-based retrospective cohort study of 98,700 patients aged ≥50 years with or without COPD using a national administrative claims dataset.Materials and MethodsThe patients were divided into COPD and comparison groups comprising 19,740 and 78,960 patients, respectively. The groups were 1 to 4 matched for age, gender, index date, diabetes mellitus, pre-existing osteoporosis and chronic kidney disease. Information such as the geographic area where southern part represented more sunshine exposure, smoking-related diagnoses, alcohol use disorder, whether there was regular use of inhaled corticosteroids and oral corticosteroids, vitamin D prescriptions, Charlson-Deyo comorbidity index score, and other relevant medical comorbidities were extracted for analysis. They were followed up until OTPF or the end of the year 2013. The outcome measure was an osteoporotic vertebral fracture and other long-bone fractures. A multivariate Cox model was constructed to derive adjusted hazard ratios (aHR) for OTPF with corresponding 95% confidence intervals (CI) after controlling for age, sex, insurance premium category, vitamin D prescription, osteoporosis, and coronary heart disease (CHD). Kaplan–Meier curves of the probability of OTPF-free survival for each cohort were compared using the log-rank test. Patients with OTPF during the first follow-up year were excluded from the overall risk calculation. Contributing factors to the increased risk of OTPF in COPD patients were examined in a sensitivity analysis.ResultsAfter a total follow-up of 68,743 patient-years for the COPD group and 278,051 patient-years for the matched comparison group, the HR for OTPF was 1.24 (95% CI [1.02–1.51]; P = 0.0322) in COPD patients. The aHR was increased by 30% for vertebral OTPF (aHR = 1.297, 95% CI [1.020–1.649]; P = 0.0339). Differential lag time sensitivity analysis revealed a progressively elevated risk up to 8-fold increase in women (aHR = 8.0 (95% CI [1.81–35.4]; P < 0.01)) during the fifth follow-up year. COPD patients with pre-existing osteoporosis or given vitamin D prescription harbor a sustained increased risk up to the 5th (aHR, 4.1; 95% CI [1.61–10.35]) and third (aHR, 2.97; 95% CI [1.48–5.97]) follow-up year, respectively.ConclusionsOur nationwide population-based cohort study demonstrates that East Asian COPD patients aged 50 and beyond do harbor a modestly increased risk for osteoporotic vertebral fractures particularly for those who are female, have pre-existing osteoporosis or require vitamin D prescription.

show abstract

“…Since that time a number of interesting manuscripts have been published that expand this area. In this issue of COPD: Journal of Chronic Obstructive Pulmonary Disease, a group of researchers from Japan studied a small, predominantly male COPD cohort to probe what factors predict vertebral fractures in COPD subjects (3). Th e paper highlights the reason that we screen for osteoporosis or bone loss: What is the future fracture risk?…”

mentioning

confidence: 98%

It's the Fracture that Matters –Bone Disease in COPD Patients

Regan

Jaramillo

2012

COPD: Journal of Chronic Obstructive Pulmonary Disease

View full text Add to dashboard Cite

Predictors of Osteoporosis and Vertebral Fractures in Patients Presenting with Moderate-to-Severe Chronic Obstructive Lung Disease

Cited by 50 publications

References 21 publications

High Imminent Vertebral Fracture Risk in Subjects With COPD With a Prevalent or Incident Vertebral Fracture

High Imminent Vertebral Fracture Risk in Subjects With COPD With a Prevalent or Incident Vertebral Fracture

Risk and clinical predictors of osteoporotic fracture in East Asian patients with chronic obstructive pulmonary disease: a population-based cohort study

It's the Fracture that Matters –Bone Disease in COPD Patients

Contact Info

Product

Resources

About