Bone screening recommended for COPD veterans
MedWire News: Male veterans with chronic obstructive pulmonary disease (COPD) should be screened for osteoporosis, say US researchers who found a high untreated prevalence of the disease in this population.
"Recent studies implicate [COPD] in the development of osteopenia/osteoporosis secondary to an inflammatory process independent of steroid use," explained presenting author Kathleen Ellstrom (Veterans Administration Loma Linda Healthcare System, California) in a press release. "Additionally, the use of steroids for exacerbations in lung disease place patients at increased risk."
The team recommended dual-emission X-ray absorptiometry (DXA) screening for all patients referred to a Veteran Affairs pulmonary rehabilitation program; over a 2-year period bone mineral density was determined in 43 of 46 eligible patients with COPD (80%), idiopathic pulmonary fibrosis (16%), or asthma (4%).
All but 2% of the veteran patients were male, and the average was 69 years. Most patients were White (72%), 17% were Black, and 11% were Hispanic/Latino.
Patients had a Global Initiative for Obstructive Lung Disease stage classification of II (moderate, 33%), III (severe, 48%), and IV (very severe, 19%), and 59% had elevated C-reactive protein.
Overall, 63% of patients had an abnormal DXA scan result, with 78% diagnosed with osteopenia, and 22% with osteoporosis. The risk for low BMD was significantly associated with disease severity, the researchers report.
Patients with low bone mineral density were treated with antiresporptive agents, and daily calcium 500 mg and vitamin D 2000 U.
"Male veterans with pulmonary disease are at risk for bone disease," Ellstrom et al conclude.
"The prevalence of osteopenia/osteoporosis is very high in this population and routine screening may help to reduce fractures."
The research was presented at the American Thoracic Society International Conference, held in San Francisco, California, USA.
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By Lynda Williams