title: [Osteoporosis in men with chronic obstructive pulmonary disease. Utility of phalangeal densitometry (AccuDEXA) as a screening method].
abstract: OBJECTIVE
  To analyze the prevalence of osteoporosis in men with chronic obstructive pulmonary disease (COPD) and to evaluate whether phalangeal densitometry (AccuDEXA) could be a useful screening method for identifying osteoporosis in these patients.
  
  
  METHODS
  We performed a cross sectional study in male patients with COPD who were assessed by a pulmonologist in primary care and in our hospital as out-patients. The diagnosis of osteoporosis was established by conventional DEXA (lumbar spine and total hip), according to the WHO criteria. Bone mineral density (BMD) was assessed by AccuDEXA. We used a ROC curve to determine the best cut-off point for screening with this technique.
  
  
  RESULTS
  One hundred fifty male patients with COPD were included. The mean age was 67 ± 3 years. The prevalence of osteoporosis by DEXA was 34%. BMD in phalanx was significantly correlated with BMD in lumbar spine and hip (r: 0.6). The sensitivity and specificity of AccuDEXA in identifying osteoporosis was 29% and 85%, respectively. The best cut-off point for AccuDEXA was a T-score of -0.8 (sensitivity 85%, specificity 63%, positive predictive value 56%, negative predictive value 89%). Glucocorticoid treatment and COPD severity were significantly associated with the presence of osteoporosis in these patients (p=0.005 and p=0.023 respectively).
  
  
  CONCLUSIONS
  The prevalence of osteoporosis in men with COPD is high. This complication seems to be associated with glucocorticoid treatment and COPD severity. AccuDEXA could be a useful screening method for osteoporosis in these patients and could almost halve the number of conventional DEXAs performed.
authors.affiliation: Unidad de Reumatología. Hospital de Sabadell. Institut Universitari Parc Taulí. Universidad Autónoma de Barcelona. Sabadell. Barcelona. España.
authors.forename: E
authors.initials: E
authors.lastname: Casado
authors.forename: M
authors.initials: M
authors.lastname: Larrosa
authors.forename: E
authors.initials: E
authors.lastname: Naval
authors.forename: M
authors.initials: M
authors.lastname: Gallego
authors.forename: A
authors.initials: A
authors.lastname: Gómez
authors.forename: C
authors.initials: C
authors.lastname: Domingo
authors.forename: J
authors.initials: J
authors.lastname: Gratacós