title: African Americans and men with severe COPD have a high prevalence of osteoporosis.
abstract: Osteoporosis is a non-pulmonary manifestation whose true prevalence is uncertain in severe chronic obstructive pulmonary disease (COPD). We describe the prevalence and risk factors for osteoporosis in a large, well characterized COPD cohort. Dual energy x-ray absorptiometry of the lumbar spine and hip, full pulmonary function testing, cardiopulmonary exercise test, 6 minute walk distance and demographics were performed in 179 non-selected COPD patients. Patients were 59 +/- 7 years old, smoked 53 +/- 32 pack years, FEV(1) 26% +/- 9.8, and 45% were currently taking prednisone. Bone mineral density measurements were abnormal in 97%; 66% had dual energy X-ray absorptiometry defined osteoporosis, while 31% had osteopenia. The prevalence of osteoporosis in males versus females was 70% versus 62% (p = 0.33); both groups had similar fracture rates. The prevalence of osteoporosis in African Americans versus Caucasians was 69% versus 65% (p = 0.78). Caucasians had a significantly lower Ward's Triangle T score than African Americans (-2.52 +/- -0.96 vs. -2.16 +/- -0.91, p = 0.04). Those with bone fractures took higher doses of prednisone than those without fractures. Univariate analysis identified BMI and FVC% as predictors for osteoporosis (p = 0.03 OR 0.934 p = 0.006 OR 0.974). Multivariate analysis revealed only FVC% as a significant predictor (p = 0.006, OR 0.974). Osteoporosis is highly prevalent in severe COPD, and affects males and African Americans to a similar degree as females and Whites. Osteoporosis should be considered in severe COPD regardless of race or gender.
authors.affiliation: Division of Pulmonary and Critical Care, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA. lilihuaorc@gmail.com
authors.forename: Lihua
authors.initials: L
authors.lastname: Li
authors.forename: Kathleen J
authors.initials: KJ
authors.lastname: Brennan
authors.forename: John P
authors.initials: JP
authors.lastname: Gaughan
authors.forename: David E
authors.initials: DE
authors.lastname: Ciccolella
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Kuzma
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: Criner
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D015519:Bone Density; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D015775:Fractures, Stress / Q000453:epidemiology / Q000208:ethnology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010024:Osteoporosis / Q000208:ethnology*; D015143:Philadelphia / Q000453:epidemiology; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000145:classification / Q000208:ethnology*; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors