title: Osteoporosis before lung transplantation: association with low body mass index, but not with underlying disease.
abstract: Due to progress in lung transplantation, post-transplantation osteoporosis becomes an important problem. We determined bone mineral density (BMD) in 74 lung transplantation candidates, among them 24 patients with cysticfibrosis, 16 with chronic obstructive pulmonary disease, 14 with pulmonary fibrosis, and 11 with pulmonary hypertension. The mean T score (+/- SD) was -2.6 +/- 1.3 at femoral neck (FN), -2.2 +/- 1.6 at Ward's triangle (WT) and -2.3 +/- 1.5 at lumbar spine (LS). Osteoporosis was found in 61% of the patients at FN, 45% at WT and 50% at LS. Patients with different underlying lung diseases were similarly affected, not only those with cystic fibrosis but also others, including patients with pulmonary hypertension. No association was found between BMD and age, gender, menstrual condition in women and testosterone level in men. A negative correlation was found between chronic glucocorticoid use and T scores. Body mass index correlated positively (p < 0.01) with T scores at any site and the correlation was also significant for the 2 largest subgroups. Loss of lung function (FEV1) also was associated with lower T scores. No correlation was found between BMD and biochemical indices of bone turnover. Multivariate analysis revealed BMI and glucocorticoid use as independent risk factors. We conclude that osteoporosis is a very common condition in patients with end-stage pulmonary disease, independent of the underlying diagnosis. In view of additional bone loss under immunosuppressive treatment after lung transplantation, early diagnosis and prevention of osteoporosis in the pretransplant period should receive high priority.
authors.affiliation: Division of Pulmonary Medicine, University Hospital, Zurich, Switzerland.
authors.forename: Oliver
authors.initials: O
authors.lastname: Tschopp
authors.forename: Annette
authors.initials: A
authors.lastname: Boehler
authors.forename: Rudolf
authors.initials: R
authors.lastname: Speich
authors.forename: Walter
authors.initials: W
authors.lastname: Weder
authors.forename: Burkhardt
authors.initials: B
authors.lastname: Seifert
authors.forename: Erich W
authors.initials: EW
authors.lastname: Russi
authors.forename: Christoph
authors.initials: C
authors.lastname: Schmid
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D001842:Bone and Bones / Q000378:metabolism; D003550:Cystic Fibrosis / Q000150:complications / Q000601:surgery; D005260:Female; D005541:Forced Expiratory Volume; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006976:Hypertension, Pulmonary / Q000601:surgery; D016040:Lung Transplantation / Q000502:physiology*; D008297:Male; D008597:Menstrual Cycle / Q000502:physiology; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000601:surgery; D011658:Pulmonary Fibrosis / Q000601:surgery; D012189:Retrospective Studies; D013739:Testosterone / Q000097:blood
chemical_list: D005938:Glucocorticoids; D013739:Testosterone