title: Low bone mineral density in men with chronic obstructive pulmonary disease.
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.
authors.affiliation: Section of Respiratory Medicine, Wales Heart Research Institute, School of Medicine, Cardiff University, University Hospital of Wales, Heath Park, Cardiff, CF14 4XN, UK. jamie.duckers@wales.nhs.uk
authors.forename: James M
authors.initials: JM
authors.lastname: Duckers
authors.forename: Bronwen A J
authors.initials: BA
authors.lastname: Evans
authors.forename: William D
authors.initials: WD
authors.lastname: Fraser
authors.forename: Michael D
authors.initials: MD
authors.lastname: Stone
authors.forename: Charlotte E
authors.initials: CE
authors.lastname: Bolton
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Shale
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000097:blood / Q000209:etiology* / Q000473:pathology; D016723:Bone Remodeling; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D024042:Collagen Type I / Q000097:blood; D005541:Forced Expiratory Volume; D006621:Hip Joint / Q000473:pathology*; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology*; D008168:Lung / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood; D010024:Osteoporosis / Q000097:blood / Q000209:etiology* / Q000473:pathology; D010446:Peptide Fragments / Q000097:blood; D010455:Peptides / Q000097:blood; D011347:Procollagen / Q000097:blood; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D012044:Regression Analysis; D012129:Respiratory Function Tests; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013256:Steroids / Q000008:administration & dosage; D014852:Wales
chemical_list: D015415:Biomarkers; D024042:Collagen Type I; D010446:Peptide Fragments; D010455:Peptides; D011347:Procollagen; D013256:Steroids; C052929:collagen type I trimeric cross-linked peptide; C042813:procollagen type I carboxy terminal peptide; D015675:Osteocalcin