Factors associated with osteoporosis in patients with chronic obstructive pulmonary disease—a nationwide retrospective study

• Published in: Osteoporosis international 2017, Vol.28 (1), p.359-367
• Main Authors: Lu, P.-C., Yang, Y.-H., Guo, S.-E., Yang, T.-M.
• Format: Article
• Language: English
• Subjects: Adult; Age; Age Distribution; Aged; Aged, 80 and over; Chronic obstructive pulmonary disease; Corticosteroids; Drug Utilization - statistics & numerical data; Endocrinology; Female; Glucocorticoids - adverse effects; Health risk assessment; Humans; Incidence; Lung diseases; Male; Medical personnel; Medicine; Medicine & Public Health; Middle Aged; Obstructive lung disease; Original Article; Orthopedics; Osteoporosis; Osteoporosis - complications; Osteoporosis - epidemiology; Pulmonary Disease, Chronic Obstructive - epidemiology; Pulmonary Disease, Chronic Obstructive - etiology; Regression analysis; Retrospective Studies; Rheumatology; Risk Factors; Sex; Sex Distribution; Socioeconomic Factors; Steroid hormones; Studies; Taiwan - epidemiology
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-016-3732-2

Summary The present study aimed to identify the factors associated with osteoporosis in patients with chronic obstructive pulmonary disease in Taiwan. The study found that female sex, old age, and use of a high dose of oral corticosteroids were significantly associated with osteoporosis in these patients. Introduction Chronic obstructive pulmonary disease (COPD) is becoming an increasingly serious and prevalent issue worldwide. The treatment of COPD with long-term steroid use may cause osteoporosis and have significant influences on disability and mortality. However, few studies have evaluated the association between steroid use and osteoporosis in patients with COPD. The present study aimed to identify the factors, including demographic characteristics and steroid use (oral corticosteroids [OCSs], inhaled corticosteroids, and injected steroids), associated with osteoporosis in patients with COPD in Taiwan. Methods This was a retrospective case-control study. Data were obtained from the National Health Insurance Research Database from 1997 to 2009. Cox proportional hazard regression models were used to identify the factors associated with osteoporosis. Results The incidence of osteoporosis in the patients with COPD was 1343.0 per 100,000 person-years, the majority of patients were women (63.6 %), and the mean age of the patients was 72.5 years. In multivariate regression analysis, female sex, old age, and use of a high OCS dose with a defined daily dose (DDD) >56 (hazard ratio 1.85, 95 % confidence interval 1.52–2.26, P  56 are associated with osteoporosis in patients with COPD. Additionally, female patients >50 years old and male patients >70 years old have a higher risk of osteoporosis. Medical personnel should actively provide health education for the prevention of osteoporosis in these patients.