Relationship Between Pulmonary Emphysema and Osteoporosis Assessed by CT in Patients With COPD

Ohara, Tadashi; Hirai, Toyohiro; Muro, Shigeo; Haruna, Akane; Terada, Kunihiko; Kinose, Daisuke; Marumo, Satoshi; Ogawa, Emiko; Hoshino, Yuma; Niimi, Akio; Chin, Kazuo; Mishima, Michiaki

doi:10.1378/chest.07-3054

Cited by 146 publications

(149 citation statements)

References 27 publications

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“…However, COPD itself may be a risk factor for osteoporosis and this may be related to systemic inflammation. Using computed tomography (CT) to determine bone density of thoracic vertebrae, there is a significant correlation between CT-measured emphysema and bone density, supporting the view that osteoporosis is related to emphysema [126]. There is some evidence that osteoporosis is also associated with an increased risk of atherosclerosis and heart disease in patients without COPD [109].…”

Section: Osteoporosismentioning

confidence: 94%

Systemic manifestations and comorbidities of COPD

Barnes¹,

Celli²

2009

Eur Respir J

1,476

1,113

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Increasing evidence indicates that chronic obstructive pulmonary disease (COPD) is a complex disease involving more than airflow obstruction. Airflow obstruction has profound effects on cardiac function and gas exchange with systemic consequences. In addition, as COPD results from inflammation and/or alterations in repair mechanisms, the ''spill-over'' of inflammatory mediators into the circulation may result in important systemic manifestations of the disease, such as skeletal muscle wasting and cachexia. Systemic inflammation may also initiate or worsen comorbid diseases, such as ischaemic heart disease, heart failure, osteoporosis, normocytic anaemia, lung cancer, depression and diabetes. Comorbid diseases potentiate the morbidity of COPD, leading to increased hospitalisations, mortality and healthcare costs. Comorbidities complicate the management of COPD and need to be evaluated carefully. Current therapies for comorbid diseases, such as statins and peroxisome proliferator-activated receptor-agonists, may provide unexpected benefits for COPD patients. Treatment of COPD inflammation may concomitantly treat systemic inflammation and associated comorbidities. However, new broad-spectrum anti-inflammatory treatments, such as phosphodiesterase 4 inhibitors, have significant side-effects so it may be necessary to develop inhaled drugs in the future. Another approach is the reversal of corticosteroid resistance, for example with effective antioxidants. More research is needed on COPD comorbidities and their treatment.

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Section: Osteoporosismentioning

confidence: 94%

Systemic manifestations and comorbidities of COPD

Barnes¹,

Celli²

2009

Eur Respir J

1,476

1,113

View full text Add to dashboard Cite

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“…Additionally, systemic inflammation, the use of systemic corticosteroids and the high prevalence of vitamin D deficiency, which are frequently observed in more severe stages of COPD, unequivocally contribute to a further loss of bone and muscle mass [43,45]. Observational studies also suggest that emphysema represents a particular phenotype that is associated with musculoskeletal impairment but the underlying mechanisms remain unclear [46][47][48]. Bone tissue is continuously renewed throughout life.…”

Section: Bone Mineral Density Lossmentioning

confidence: 99%

Nutritional assessment and therapy in COPD: a European Respiratory Society statement

et al. 2014

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Nutrition and metabolism have been the topic of extensive scientific research in chronic obstructive pulmonary disease (COPD) but clinical awareness of the impact dietary habits, nutritional status and nutritional interventions may have on COPD incidence, progression and outcome is limited. A multidisciplinary Task Force was created by the European Respiratory Society to deliver a summary of the evidence and description of current practice in nutritional assessment and therapy in COPD, and to provide directions for future research. Task Force members conducted focused reviews of the literature on relevant topics, advised by a methodologist. It is well established that nutritional status, and in particular abnormal body composition, is an important independent determinant of COPD outcome. The Task Force identified different metabolic phenotypes of COPD as a basis for nutritional risk profile assessment that is useful in clinical trial design and patient counselling. Nutritional intervention is probably effective in undernourished patients and probably most when combined with an exercise programme. Providing evidence of costeffectiveness of nutritional intervention is required to support reimbursement and thus increase access to nutritional intervention. Overall, the evidence indicates that a well-balanced diet is beneficial to all COPD patients, not only for its potential pulmonary benefits, but also for its proven benefits in metabolic and cardiovascular risk. @ERSpublications Metabolism and nutrition: shifting paradigms in COPD management

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“…28 Sup por ting this, we ob ser ved sig ni fi cant cor re la ti on with VTS and FEV 1 % or FEV 1 /FVC sho wing that os te o po rosis risk in cre a sed as COPD prog res ses. The progres si on of COPD might ha ve led to os te o po ro sis as such sub jects might ha ve ne e ded mo re CS; the se sub jects with se ve re hypo xe mi a might ha ve dec rea sed mo bi lity and sun light ex po su re furt her af fecting the bo ne me ta bo lism ne ga ti vely.…”

Section: Discussionmentioning

confidence: 59%

Decreased Bone Density in Chronic Obstructive Pulmonary Disease Patients

Argüder¹,

Karnak²,

Kayacan³

et al. 2010

Turkiye Klinikleri J Med Sci

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A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The clinical course of patients with chronic obstructive pulmonary disease (COPD) is often complicated by the development of systemic effects one of which is osteoporosis. The purpose of this study was to investigate potential risk factors for osteoporosis in COPD patients. M Ma at te er ri ia al l a an nd d M Me et th h--o od ds s: : We conducted a cross-sectional study in 45 consecutive males with COPD recruited from the outpatient clinic. Demographic data were recorded. Pulmonary function tests [percent of predicted forced expiratory volume in 1 second (FEV1%), forced vital capacity (FVC), FEV1/FVC ratio], maximal inspiratory and expiratory pressures (MIP and MEP), arterial blood gas (ABG) analyses, endocrine tests related to bone density and bone mineral density parameters (vertebral "T" scores (VTS) and femoral "T" scores (FTS)) were performed. Patients were allocated into three groups consisting of 15 patients each, according to history of corticosteroid (CS) use: Patients who have never used any CS, subjects who have been on inhaled steroids (fluticasone dose equivalent to at least 250µg.day-1 propionate or 400µg.day-1 budesonide for at least 36 months) or systemic steroids (methylprednisolone mean dose of at least equivalent to 20mg.day-1 of for at least two weeks). R Re es su ul lt ts s: : Three groups were not different regarding osteoporosis. However, in systemic CS group MEP and calcitonin levels were lower than those of inhaled CS group and never CS group (p<0.05 for each). VTS was positively correlated with partial arterial oxygen concentration (PaO2), arterial oxygen saturation % (SaO2) and body mass index (BMI) (r=0.44, p<0.01; r=0.49, p<0.01, r=0.34, p<0.05 respectively). FTS was only well correlated with BMI(r=0.34, p<0.05). C Co on nc cl lu us si io on n: : Bone densities were similar into three groups. Parameters related with severity of COPD such as bronchoconstruction and hypoxemia, along with low BMI were found as risk factors in the development of osteoporosis in COPD patients. Preserved MEP and calcitonin levels in inhaled CS group suggested that respiratory muscle strength and bone resorption were not affected by inhaled CS opposite to systemic steroids. K Ke ey y W Wo or rd ds s: : Pulmonary disease, chronic obstructive; body mass index; osteoporosis; adrenal cortex hormones Ö ÖZ ZE ET T A Am ma aç ç: : Kronik Obstrüktif Akciğer Hastalığı (KOAH) tanılı olguların klinik seyri sıklıkla, osteoporoz gibi, hastalığa bağlı sistemik etkilerin görülmesiyle komplike hale gelir. Bu çalışmanın amacı KOAH'lı olgularda osteoporoz gelişimindeki olası risk faktörlerini araştırmaktır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Bu kesitsel çalışmada polikliniğe başvuran 45 sıralı KOAH'lı olgu incelenmiştir. Olguların demografik verileri ve ayrıntılı öyküleri kaydedilmiştir. Solunum fonksiyon testleri (SFT) [1.saniye zorlu akım hızı beklenen yüzdesi (FEV1%), zorlu vital kapasite (FVC), FEV1'in FVC'ye oranı (FEV1/FVC)], maksimal inspirat...

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Relationship Between Pulmonary Emphysema and Osteoporosis Assessed by CT in Patients With COPD

Cited by 146 publications

References 27 publications

Systemic manifestations and comorbidities of COPD

Systemic manifestations and comorbidities of COPD

Nutritional assessment and therapy in COPD: a European Respiratory Society statement

Decreased Bone Density in Chronic Obstructive Pulmonary Disease Patients

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