Osteoporosis risk highlighted in COPD patients
MedWire News: Individuals with chronic pulmonary obstructive disease (COPD) should have their bone mineral density (BMD) monitored, say Brazilian researchers who found a high prevalence of osteoporosis in patients with the condition.
Importantly, the link between osteoporosis and COPD occurred after adjusting for use of systemic glucocorticoids, a known risk factor for bone loss, reports the team from Serviço de Endocrinologia e Metabologia do Hospital de Clínicas da Universidade Federal do Paraná in Curitiba.
Victoria Borba and co-workers measured BMD and other markers of bone metabolism in 21 men and 28 postmenopausal women with COPD.
When BMD results were compared with values from 40 healthy non-smoking individuals matched by age, gender, ethnicity and body mass index, the COPD patients had significantly lower levels of BMD at the lumbar spine, femoral neck, and total femur.
Overall, 51% of the COPD patients were diagnosed with osteoporosis and 94% of COPD patients had insufficient levels of vitamin D levels, defined as below 30 ng/ml. In addition, 67% were diagnosed with secondary hyperparathyroidism.
Vitamin D levels were associated with oxygen saturation levels in the COPD patients, with the lowest vitamin levels in patients with saturation of less than 88%.
In multiple regression analysis, there was a significant correlation between BMD and body weight, and between BMD and forced expiratory volume in 1 second, so that the two factors explained around 40% of variability in BMD at the three different bone sites.
However, there was no correlation between BMD and use of inhaled glucocortiocoids or smoking, or between vitamin D levels and glucocorticoids or smoking.
“We suggest that patients with COPD should routinely have their BMD evaluated, even in the absence of severe disease or use of glucocorticoids,” Borba et al conclude.
“In addition, supplementation of vitamin D may be needed in all patients with COPD, especially to those with oxygen saturation less than 88%.”
They recommend: “Future studies need to evaluate long-term risk of fractures and the outcomes after routine BMD screening and vitamin D supplementation in patients with COPD.”
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By Lynda Williams