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Sim, Lee, Ryu, Chun, and Chang: Prevalence and Risk Factors of Osteoporosis in Patients with Chronic Obstructive Pulmonary Disease
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2009; 66(3): 186-191.

Published online: 31 March 2009

DOI: https://doi.org/10.4046/trd.2009.66.3.186

Prevalence and Risk Factors of Osteoporosis in Patients with Chronic Obstructive Pulmonary Disease

Yun Su Sim, M.D.1, Jin Hwa Lee, M.D.1, 2, Yon Ju Ryu, M.D.1, Eun Mi Chun, M.D.1, Jung Hyun Chang, M.D.1

1Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.

2Clinical Research Center for Chronic Obstructive Airway Diseases, Seoul, Korea.

Address for correspondence: Jin Hwa Lee, M.D. Department of Internal Medicine, School of Medicine, Ewha Womans University, 911-1, Mok-dong, Yancheon-gu, Seoul 158-710, Korea. Phone: 82-2-2650-6007, Fax: 82-2-2655-2076, jinhwalee@ewha.ac.kr

Received 22 January 2009       Accepted 6 March 2009

Copyright©2009. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Background

Osteoporosis is a significant comorbidity in patients with chronic obstructive pulmonary disease (COPD). This study examined the prevalence and risk factors associated with osteoporosis in patients with COPD.

Methods

The bone mineral densities (BMDs) of the lumbar spine and femoral bone were measured in 53 patients with clinically stable COPD and 41 age- and gender-matched control subjects showing a normal lung function. Osteoporosis was defined as a T-score ≤-2.5. The subjects' clinical characteristics and laboratory data were reviewed, and multiple logistic regression analysis was used to identify the risk factors associated with osteoporosis in COPD patients.

Results

The prevalence of osteoporosis was 47% and 32% in the COPD patients and controls, respectively. In particular, using the femoral neck T-score, the prevalence of osteoporosis in COPD patients was higher than that in the controls (26% vs. 5%; p=0.006). The average T-score of the lumbar spine (p=0.025) and femoral neck of COPD patients were significantly lower than those of the controls (p=0.001). The forced expiratory volume in the 1 second (FEV1) % predicted (p=0.019; odds ratio [OR], 0.955; 95% confidence interval [CI], 0.919-0.993) and age (p=0.024; OR, 1.144; 95% CI, 1.018-1.287) were independently associated with osteoporosis in patients with COPD.

Conclusion

Using the femoral neck T-score, the prevalence of osteoporosis in patients with COPD was higher than the age-and gender-matched controls. A lower FEV1 and older age further increase the risk of osteoporosis in patients with COPD.

Keywords: Chronic obstructive pulmonary disease, Osteoporosis, Prevalence, Risk factor, Lung function

Figures and Tables

Table 1
Clinical characteristics in patients with COPD and age- and sex-matched control subjects
trd-66-186-i001

Data are mean±standard deviation (SD) or number (frequency).

COPD: chronic obstructive pulmonary disease; BMI: body mass index; NS: not significant.

Table 2
Lung function in patients with COPD and age- and sex-matched controls
trd-66-186-i002

Data are mean±SD.

COPD: chronic obstructive pulmonary disease; FEV1: forced expiratory volume in 1 second; FVC: forced vital capacity.

Table 3
Laboratory data in patients with COPD and age- and sex-matched controls
trd-66-186-i003

Data are mean±SD.

COPD: chronic obstructive pulmonary disease; CRP: C-reactive protein; ESR: erythrocyte sedimentation rate; NS: not significant.

Table 4
Comparison of bone density parameters and prevalence of osteoporosis in patients with COPD and age- and sex-matched controls
trd-66-186-i004

Data are mean±SD or number (frequency).

COPD: chronic obstructive pulmonary disease; L2-4: the second, third and forth lumbar vertebrae; NS: not significant.

*Osteopenia is defined as a T-score between -1.0 and -2.5, †Osteoporosis is defined as a T-score below -2.5.

Table 5
Clinical characteristics of COPD patients according to presence of osteoporosis
trd-66-186-i005

Data are mean±SD or number (frequency).

COPD: chronic obstructive pulmonary disease; BMI: body mass index; NS: not significant.

Table 6
Lung function of COPD patients according to presence of osteoporosis
trd-66-186-i006

Data are mean±SD.

COPD: chronic obstructive pulmonary disease; FEV1: forced expiratory volume in 1 second; FVC: forced vital capacity; NS: not significant.

Table 7
Risk factors of osteoporosis in patients with COPD by multiple logistic regression analyses
trd-66-186-i007

COPD: chronic obstructive pulmonary disease; FEV1: forced expiratory volume in 1 second.

Table 8
Comparison of bone density parameters and prevalence of osteoporosis in COPD patients according to corticosteroid use
trd-66-186-i008

Data are mean±SD or number (frequency).

COPD: chronic obstructive pulmonary disease; L2-4: the second, third and forth lumbar vertebrae; NS: not significant.

*Osteopenia is defined as a T-score between -1.0 and -2.5, †Osteoporosis is defined as a T-score below -2.5.

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ORCID iDs

Jin Hwa Lee
https://orcid.org/http://orcid.org/0000-0003-0843-9862

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