nach oben

Erschienen in:

25.07.2018 | Original Article

Bone mineral density and vertebral fractures and their relationship with pulmonary dysfunction in patients with chronic obstructive pulmonary disease

verfasst von: T. Munhoz da Rocha Lemos Costa, F. M. Costa, T. Hoffman Jonasson, C. Aguiar Moreira, C. L. Boguszewski, J. L. Cunha Borges, V. Zeghbi Cochenski Borba

Erschienen in: Osteoporosis International | Ausgabe 11/2018

Einloggen, um Zugang zu erhalten

Abstract

Summary

To evaluate bone mineral density (BMD) and morphometric vertebral fractures (MVF) in chronic obstructive pulmonary disease (COPD) patients in comparison with two control groups. BMD was lower in the disease group (DG) and was associated with the worst disease severity and prognosis. The prevalence of MVF was high and greater in the DG than in the control groups.

Introduction

Chronic obstructive pulmonary disease (COPD) is associated with osteoporosis and vertebral fractures. It is still unclear whether the presence of fractures and changes in bone mineral density (BMD) are associated with disease severity and prognosis. The aim of this study was to evaluate BMD and morphometric vertebral fractures (MVF) in COPD patients in comparison with two control groups and to correlate these parameters with indices of COPD severity (VEF1 and GOLD) and prognosis (BODE).

Methods

This was a cross-sectional study in COPD patients (disease group, DG) who underwent BMD and vertebral fracture assessment (VFA). Two control groups were used: smokers without COPD (smoker group, SG) and healthy never-smoker individuals (never-smoker group, NSG).

Results

The DG comprised 121 patients (65 women, mean age 67.9 ± 8.6 years). Altered BMD was observed in 88.4% of the patients in the DG, which was more prevalent when compared with the control groups (p < 0.001). The BMD values were lower in the DG than in the control groups (p < 0.05). BMD was associated with the worst disease severity and prognosis (p < 0.05). The prevalence of MVF was high (57.8%) and greater than that in the SG (23.8%) and the NSG (14.8%; p < 0.001). The prevalence of fractures was not associated with disease severity and prognosis.

Conclusions

COPD patients have a higher prevalence of MVF and low BMD, and the latter was associated with the severity and poor prognosis of the disease.

Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease. National Heart, Lung and Blood Institutes. Revised 2011. www.goldcopd.com

Cielen N, Maes K, Gayan-Ramirez G (2014) Musculoskeletal disorders in chronic obstructive pulmonary disease. Biomed Res Int 2014:96576CrossRef

Eagan TM, Aukrust P, Upland T, Hardier JA, Johannessen A, Mollnes TE et al (2010) Body composition and plasma levels of inflammatory biomarkers in COPD. Eur Respir J 36(5):1027–1033CrossRef

Decramer M, Janssens W, Miravitlles M (2012) Chronic obstructive pulmonary disease. Lancet 379(9823):1341–1351CrossRef

Miller J, Edwards LD, Agustí A, Bakke P, Calverley PM, Celli B et al (2013) Evaluation of COPD longitudinally to identify predictive surrogate endpoints (ECLIPSE) investigators. Comorbidity, systemic inflammation and outcomes in the ECLIPSE cohort. Respir Med 107(9):1376–1384CrossRef

Franco CB, Paz-Filho G, Gomes PE, Nascimento VB, Kulak CA, Boguszewski CL et al (2009) Chronic obstructive pulmonary disease is associated with osteoporosis and low levels of vitamin D. Osteoporos Int 20(11):1881–1887CrossRef

Graat-Verboom L, Wouters EF, Smeenk FW, van den Borne BE, Lunde R, Spruit MA (2009) Current status of research on osteoporosis in COPD: a systematic review. Eur Respir J 34:209–218CrossRef

Yamamoto Y, Yoshikawa M, Tomoda K, Fujita Y, Yamauchi M, Fukuoka A et al (2014) Distribution of bone mineral content is associated with body weight and exercise capacity in patients with chronic obstructive pulmonary disease. Respiration 87(2):158–164CrossRef

Fouda MA, Alhamad EH, Al-Hajjaj MS, Shaik SA, Alboukai AA, Al-Kassimi FA (2017) A study of chronic obstructive pulmonary disease-specific causes of osteoporosis with emphasis on the emphysema phenotype. Ann Thorac Med 12(2):101–106CrossRef

10.

Hamdy RC (2016) Bone mineral density and fractures. J Clin Densitom 19(2):125–126CrossRef

11.

Nuti R, Siviero P, Maggi S, Guglielmi G, Caffarelli C, Crepaldi G et al (2009) Vertebral fractures in patients with chronic obstructive pulmonary disease: the EOLO Study. Osteoporos Int 20(6):989–998CrossRef

12.

Schlaich C, Minne HW, Bruckner T (1998) Reduced pulmonary function in patients with spinal osteoporotic fractures. Osteoporos Int 8:261–267CrossRef

13.

Silva DR, Coelho AC, Dumke A, Valentini JD, de Nunes JN, Stefani CL et al (2011) Osteoporosis prevalence and associated factors in patients with COPD: a cross-sectional study. Respir Care 56(7):961–968CrossRef

14.

Ogura-Tomomatsu H, Asano K, Tomomatsu K, Miyata J, Ohmori N, Kodama M et al (2012) Predictors of osteoporosis and vertebral fractures in patients presenting with moderate-to-severe chronic obstructive lung disease. COPD 9(4):332–337CrossRef

15.

Koo HK, Park JH, Park HK, Jung H, Lee SS (2014) Conflicting role of sarcopenia and obesity in male patients with chronic obstructive pulmonary disease: Korean National Health and Nutrition Examination Survey. PLoS One 9(10):e110448CrossRef

16.

Soriano JB, Visick GT, Muellerova H, Payvandi N, Hansell AL (2005) Patterns of comorbidities in newly diagnosed COPD and asthma in primary care. Chest 128(4):2099–2107CrossRef

17.

World Health Organ (2000) Obesity: preventing and managing the global epidemic. Report of a WHO consultation. Tech Rep Ser 894:i–xii 1–253

18.

(2015) 6th ISCD position development conference (adult). www.iscd.org

19.

Genant HK, Jergas M, Palermo L, Nevitt M, Valentin RS, Black D et al (1996) Comparison of semiquantitative visual and quantitative morphometric assessment of prevalent and incident vertebral fractures in osteoporosis The Study of Osteoporotic Fractures Research Group. J Bone Miner Res 11(7):984–996CrossRef

20.

Prignot J (1987) Quantification and chemical markers of tobacco-exposure. Eur J Respir Dis 70(1):1–7PubMed

21.

Ferris BG (1978) Epidemiology standardization project (American Thoracic Society). Am Rev Respir Dis 118(6 Pt 2):1–120PubMed

22.

Jones PW, Harding G, Berry P (2009) Development and first validation of the COPD assessment test. Eur Respir J 34(3):648–654CrossRef

23.

Balke B (1963) A simple field test for the assessment of physical fitness. Rep 63–6. Rep Civ Aeromed Res Inst US

24.

Celli B, Cote C, Marin J (2004) The body mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med 350:1005–1012CrossRef

25.

Stern DA, Morgan WJ, Wright AL, Guerra S, Martinez FD (2007) Poor airway function in early infancy and lung function by age 22 years: a non-selective longitudinal cohort study. Lancet 370(9589):758–764CrossRef

26.

Hunninghake GM, Cho MH, Tesfaigzi Y, Soto-Quiros ME, Avila L, Lasky-Su J, Stidley C et al (2009) MMP12, lung function, and COPD in high-risk populations. N Engl J Med 361(27):2599–2608CrossRef

27.

Pinheiro MM, Ciconelli RM, Martini LA, Ferraz MB (2009) Clinical risk factors for osteoporotic fractures in Brazilian women and men: the Brazilian Osteoporosis Study (BRAZOS). Osteoporos Int 20(3):399–408CrossRef

28.

Sakurai-Iesato Y, Kawata N, Tada Y, Iesato K, Matsuura Y, Yahaba M et al (2017) The relationship of bone mineral density in men with chronic obstructive pulmonary disease classified according to the global initiative for chronic obstructive lung disease (GOLD) combined chronic obstructive pulmonary disease (COPD) assessment system. Intern Med 56(14):1781–1790CrossRef

29.

Romme EA, Murchison JT, Edwards LD, van Beek E Jr, Murchison DM, Rutten EP et al (2013) Evaluation of COPD longitudinally to identify predictive surrogate endpoints (ECLIPSE) study investigators. CT-measured bone attenuation in patients with chronic obstructive pulmonary disease: relation to clinical features and outcomes. J Bone Miner Res 28(6):1369–1377CrossRef

30.

Watanabe R, Tanaka T, Aita K, Hagiya M, Homma T, Yokosuka K et al (2015) Osteoporosis is highly prevalent in Japanese males with chronic obstructive pulmonary disease and is associated with deteriorated pulmonary function. J Bone Miner Metab 33(4):392–400CrossRef

31.

Kjensli A, Mowinckel P, Ryg MS, Falch JA (2007) Low bone mineral density is related to severity of chronic obstructive pulmonary disease. Bone 40:493–497CrossRef

32.

Majumdar SR, Villa-Roel C, Lyons KJ, Rowe BH (2010) Prevalence and predictors of vertebral fracture in patients with chronic obstructive pulmonary disease. Respir Med 104(2):260–266CrossRef

33.

Graumam RQ, Pinheiro MM, Nery LE, Castro CHM (2018) Increased rate of osteoporosis, low lean mass, and fragility fractures in COPD patients: association with disease severity. Osteoporos Int 29:1457–1468. https://doi.org/10.1007/s00198-018-4483-z CrossRefPubMed

34.

Kulak CA, Borba VC, Jorgetti V, Dos Reis LM, Liu XS, Kimmel DB et al (2010) Skeletal microstructural abnormalities in postmenopausal women with chronic obstructive pulmonary disease. J Bone Miner Res 25(9):1931–1940CrossRef

35.

Jaramillo JD, Wilson C, Stinson DS, Lynch DA, Bowler RP, Lutz S et al (2015) Reduced bone density and vertebral fractures in smokers. Men and COPD patients at increased risk. Ann Am Thorac Soc 12(5):648–654CrossRef

Titel: Bone mineral density and vertebral fractures and their relationship with pulmonary dysfunction in patients with chronic obstructive pulmonary disease
verfasst von: T. Munhoz da Rocha Lemos Costa
F. M. Costa
T. Hoffman Jonasson
C. Aguiar Moreira
C. L. Boguszewski
J. L. Cunha Borges
V. Zeghbi Cochenski Borba
Publikationsdatum: 25.07.2018
Verlag: Springer London
Erschienen in: Osteoporosis International / Ausgabe 11/2018
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-018-4643-1

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Summary

Introduction

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 11/2018

Build better bones with exercise (B3E pilot trial): results of a feasibility study of a multicenter randomized controlled trial of 12 months of home exercise in older women with vertebral fracture

Phosphate wasting disorders in adults

A modification and validation of quantitative morphometry classification system for osteoporotic vertebral compressive fractures in mainland Chinese

Decreasing trend of bone mineral density in US multiethnic population: analysis of continuous NHANES 2005–2014

Assessment using serum insulin-like growth factor-I and bone mineral density is useful for detecting prevalent vertebral fractures in patients with type 2 diabetes mellitus