Low bone mineral density in men with chronic obstructive pulmonary disease

Osteoporosis is common in patients with COPD but the likely multi-factorial causes contributing to this condition (e.g. sex, age, smoking, therapy) mask the potential contribution from elements related to COPD. In order to study osteoporosis and bone mineral density (BMD) related to COPD, we studied...

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Bibliographic Details
Published in:	Respiratory research 2011-08, Vol.12 (99), p.101-101, Article 101
Main Authors:	Duckers, James M, Evans, Bronwen A J, Fraser, William D, Stone, Michael D, Bolton, Charlotte E, Shale, Dennis J
Format:	Article
Language:	eng
Subjects:	Absorptiometry, Photon Aged Alfacalcidol Biomarkers - blood bone biomarkers Bone Density Bone Diseases, Metabolic - blood Bone Diseases, Metabolic - etiology Bone Diseases, Metabolic - pathology bone mineral density Bone Remodeling Bones Calcifediol Case-Control Studies Chi-Square Distribution chronic obstructive pulmonary disease Collagen Collagen Type I - blood Corticosteroids Density Forced Expiratory Volume Hip Joint - pathology Humans Lumbar Vertebrae - pathology Lung - physiopathology Lung diseases, Obstructive Male Middle Aged Osteocalcin - blood Osteoporosis Osteoporosis - blood Osteoporosis - etiology Osteoporosis - pathology Peptide Fragments - blood Peptides - blood Physiological aspects Procollagen - blood Pulmonary Disease, Chronic Obstructive - complications Pulmonary Disease, Chronic Obstructive - drug therapy Pulmonary Disease, Chronic Obstructive - pathology Pulmonary Disease, Chronic Obstructive - physiopathology Regression Analysis Respiratory Function Tests Risk Assessment Risk Factors Severity of Illness Index Smokers Steroids - administration & dosage Vitamin D Wales
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Summary:	Osteoporosis is common in patients with COPD but the likely multi-factorial causes contributing to this condition (e.g. sex, age, smoking, therapy) mask the potential contribution from elements related to COPD. In order to study osteoporosis and bone mineral density (BMD) related to COPD, we studied a well-defined group of patients and controls. BMD, forced expiratory volume in one second (FEV1), circulating bone biomarkers and biochemistry were determined in 30 clinically stable male ex-smokers with confirmed COPD and 15 age matched "ex-smoker" male controls. None of the patients were on inhaled corticosteroids or received more than one short course of steroids. Mean (SD) FEV1% predicted of patients was 64(6)%, the majority having Global Initiative for Chronic Obstructive Lung Disease (GOLD) II airflow obstruction. There were 5/30 patients and 1/15 controls who were osteoporotic, while a further 17 patients and 5 controls were osteopenic. The BMD at the hip was lower in patients than controls, but not at the lumbar spine. Mean values of procollagen type 1 amino-terminal propeptide and osteocalcin, both markers of bone formation, and Type 1 collagen β C-telopeptide, a marker of bone resorption, were similar between patients and controls. However, all bone biomarkers were inversely related to hip BMD in patients (r = -0.51, r = -0.67, r = -0.57, p < 0.05) but did not relate to lumbar spine BMD. 25-OH Vitamin D was lower in patients. Men with COPD had a greater prevalence of osteoporosis and osteopenia than age matched male controls, with a marked difference in BMD at the hip. Bone biomarkers suggest increased bone turnover.
ISSN:	1465-993X 1465-9921 1465-993X