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01-11-2009 | Respiratory | Article

Osteoporosis risk highlighted in COPD patients

Abstract

Free abstract

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 such patients.

Importantly, the link between osteoporosis and COPD occurred after adjusting for use of systemic glucocorticoids for COPD, which are known to be associated with 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 bone mineral density (BMD) and other markers of bone metabolism in 21 men and 28 postmenopausal women with COPD.

When BMD results were compared with 40 healthy non-smoking individuals, 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% 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 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.

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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