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. 2011 Aug 3;12(1):101.
doi: 10.1186/1465-9921-12-101.

Low bone mineral density in men with chronic obstructive pulmonary disease

James M Duckers  1 , Bronwen A J Evans, William D Fraser, Michael D Stone, Charlotte E Bolton, Dennis J Shale
Affiliations

Low bone mineral density in men with chronic obstructive pulmonary disease

James M Duckers et al. Respir Res. .

Abstract

Background: Osteoporosis is common in patients with COPD but the likely multi-factorial causes contributing to this condition (e.g. sex, age, smoking, therapy) mask the potential contribution from elements related to COPD. In order to study osteoporosis and bone mineral density (BMD) related to COPD, we studied a well-defined group of patients and controls.

Methods: BMD, forced expiratory volume in one second (FEV1), circulating bone biomarkers and biochemistry were determined in 30 clinically stable male ex-smokers with confirmed COPD and 15 age matched "ex-smoker" male controls. None of the patients were on inhaled corticosteroids or received more than one short course of steroids.

Results: Mean (SD) FEV1% predicted of patients was 64(6)%, the majority having Global Initiative for Chronic Obstructive Lung Disease (GOLD) II airflow obstruction. There were 5/30 patients and 1/15 controls who were osteoporotic, while a further 17 patients and 5 controls were osteopenic. The BMD at the hip was lower in patients than controls, but not at the lumbar spine. Mean values of procollagen type 1 amino-terminal propeptide and osteocalcin, both markers of bone formation, and Type 1 collagen β C-telopeptide, a marker of bone resorption, were similar between patients and controls. However, all bone biomarkers were inversely related to hip BMD in patients (r = -0.51, r = -0.67, r = -0.57, p < 0.05) but did not relate to lumbar spine BMD. 25-OH Vitamin D was lower in patients.

Conclusions: Men with COPD had a greater prevalence of osteoporosis and osteopenia than age matched male controls, with a marked difference in BMD at the hip. Bone biomarkers suggest increased bone turnover.

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Figures

Figure 1
Figure 1
The T Score at the Hip and Lumbar Spine. Figure 1a T score Total Hip. Figure 1b T score Total Lumbar Spine. Shaded grey area represents osteopenia (T score -1.0 to -2.5). Osteoporosis below T score -2.5
Figure 2
Figure 2
The relationship of the BMD at the hip to bone biomarkers in Patients. Figure 2a The Marker of Bone Formation P1NP. Figure 2b The Marker of Bone Resorption CTX.
See this image and copyright information in PMC

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