Abstract

Summary

Fractures are common in individuals with COPD and occur at higher bone mass values than expected. COPD appears to be an important risk factor for bone fragility.

Introduction

Patients with chronic obstructive pulmonary disease (COPD) have an increased risk of osteoporosis and fractures, but screening and prophylactic measures to prevent both disorders are often neglected in this population. This case-control study assessed the prevalence of osteopenia, osteoporosis, and fractures in patients with COPD, and identified potential risk factors for fractures in this population.

Methods

Overall, 91 patients with COPD (COPD group; COPDG) and 81 age- and sex-matched controls (control group; CG) were assessed with bone mineral density (BMD), thoracic/lumbar spine radiographs, and serum PTH and 25-hydroxyvitamin D (25[OH]D) levels. The occurrence of prior fractures was retrieved from clinical history.

Results

The prevalence of total fractures in the COPDG was 57.1% (odds of fracture 4.7 times greater compared with the CG), and the femoral neck T-score emerged as the best predictor of fractures. Compared with the CG, the COPDG had lower spine and femoral BMD (p ≤ 0.01) and 25(OH)D levels (p = 0.01) and 2.6 times greater odds of osteoporosis. Among men, vertebral fractures were more prevalent in the COPDG versus CG (25.9% vs. 6.5%, respectively, p = 0.01). The odds of fracture increased with femoral neck T-scores ≤ − 2.7 in the CG and ≤ − 0.6 in the COPDG.

Conclusion

These results add robust evidence to an increased odds of osteoporosis and fractures in COPD. Fractures in the COPDG occurred at higher BMD values than expected, suggesting that COPD may be an independent marker of fracture risk, reinforcing a need for regular osteoporosis screening with BMD measurement and prophylaxis of fractures in patients with this disorder.

中文翻译：

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COPD是骨质疏松症和骨折的独立危险因素

摘要

概要

骨折在COPD患者中很常见，并以比预期更高的骨量值发生。COPD似乎是骨骼脆弱的重要危险因素。

介绍

患有慢性阻塞性肺疾病（COPD）的患者患骨质疏松症和骨折的风险增加，但是在该人群中经常忽略针对这两种疾病的筛查和预防措施。这项病例对照研究评估了COPD患者的骨质减少，骨质疏松和骨折的患病率，并确定了该人群骨折的潜在危险因素。

方法

总体而言，对91名COPD患者（COPD组； COPDG）和81位​​年龄和性别相匹配的对照组（对照组； CG）进行了骨矿物质密度（BMD），胸/腰椎X线摄片，血清PTH和25-羟基维生素的评估D（25 [OH] D）水平。从临床历史中可以找到先前骨折的发生情况。

结果

COPDG中总骨折的患病率为57.1％（骨折几率是CG的4.7倍），股骨颈T评分成为骨折的最佳预测指标。与CG相比，COPDG具有较低的脊柱和股骨BMD（p  ≤0.01）和25（OH）d水平（p  = 0.01）和骨质疏松症的2.6倍的可能性。在男性中，椎骨骨折在COPDG中比CG更为普遍（分别为25.9％和6.5％，p  = 0.01）。在CG中股骨颈T分数≤-2.7，在COPDG中≤-0.6时，骨折的几率增加。

结论

这些结果为COPD中骨质疏松和骨折的可能性增加提供了有力的证据。COPDG骨折的BMD值高于预期值，表明COPD可能是骨折风险的独立标志，这增加了通过BMD测量定期筛查骨质疏松症的需要，并预防了该疾病患者的骨折。