Progression of osteoporosis in patients with COPD: A 3-year follow up study

• Published in: Respiratory medicine 2012-06, Vol.106 (6), p.861-870
• Main Authors: Graat-Verboom, Lidwien, Smeenk, Frank W.J.M, van den Borne, Ben E.E.M, Spruit, Martijn A, Jansen, Frits H, van Enschot, Joris W.T, Wouters, Emiel F.M
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Body mass index; Bone density; Bone Density - physiology; Bone mineral density; Bones; Chronic Obstructive Pulmonary Disease; Chronic obstructive pulmonary disease, asthma; Co-morbidities; Disease Progression; Diseases of the osteoarticular system; Drug therapy; Female; Femur - physiopathology; Follow-Up Studies; Forced Expiratory Volume - physiology; Humans; Injuries of the limb. Injuries of the spine; Male; Medical sciences; Middle Aged; NCT00231127; Older people; Osteoporosis; Osteoporosis - etiology; Osteoporosis - physiopathology; Osteoporosis, Postmenopausal - etiology; Osteoporosis, Postmenopausal - physiopathology; Osteoporosis. Osteomalacia. Paget disease; Osteoporotic Fractures - etiology; Osteoporotic Fractures - physiopathology; Pneumology; Pulmonary Disease, Chronic Obstructive - complications; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary/Respiratory; Risk Factors; Spinal Fractures - etiology; Spinal Fractures - physiopathology; Traumas. Diseases due to physical agents; Vertebral fractures; Vitamin D Deficiency - complications
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2011.12.020

Summary Currently, our knowledge on the progression of osteoporosis and its determinants is limited in patients with chronic obstructive pulmonary disease (COPD). Bone mineral density generally remains stable in patients with COPD over a period of 3 years. Nevertheless, the progression of vertebral fractures was not assessed, while an increase of vertebral fractures over time may be reasonable. Aims of the current study were to determine the percentage of newly diagnosed osteoporotic patients after a follow up of 3 years and to identify baseline risk factors for the progression of osteoporosis in COPD. Clinically stable COPD outpatients were included. Lung function parameters, body composition measures, six minute walk distance, DXA-scan and X-spine were assessed at baseline and repeated after 3 years. Prevalence of osteoporosis in COPD patients increased from 47% to 61% in 3 years mostly due to an increase of vertebral fractures. Lower baseline T-score at the trochanter independently increased the risk for the development of osteoporosis. Additionally, baseline vitamin D deficiency increased this risk 7.5-fold. In conclusion, the prevalence of osteoporosis increased over a 3-year period in patients with COPD. Baseline risk factors for the development of osteoporosis are osteopenia at the trochanter and vitamin D deficiency.