title: Prevalence and significance of decreased bone density in pulmonary arterial hypertension.
abstract: OBJECTIVE
  Decreased bone mineral density has been found in the advanced stages of various lung diseases. Limited data are available about prevalence and risk factors for osteoporosis/osteopenia (OP) in pulmonary arterial hypertension (PAH).
  
  
  METHODS
  Patients with PAH (either idiopathic or secondary to scleroderma [SSC-PAH]) who underwent bone density testing for lung transplant evaluation were included. Results of bone density testing, demographic data, pulmonary function testing, hemodynamic measures, and 6-minute walk distance test (6MWD) were collected.
  
  
  RESULTS
  Thirty-two patients were identified (27 women/5 men, 24 idiopathic PAH/8 SSC-PAH) and OP was found in 22 (69%) patients. Patients with SSC-PAH had more significant indications of OP at all of the measured sites. The OP group had lower FEV1 (P = 0.01) and a significantly lower 6MWD (P = 0.04) as compared with patients with PAH with normal bone density. Hemodynamics indicated no statistically significant differences between the groups other than a lower mean pulmonary artery pressure (P = 0.01) in the OP group. Patients with a history of corticosteroid use and smoking, postmenopausal status, decreased functional capacity (as measured by poor New York Heart Association functional class and 6MWD), SSC-PAH, and need for oxygen during a 6MWD test had an increased risk of OP by univariate logistic regression.
  
  
  CONCLUSIONS
  Reduced bone density can be seen in a majority of patients with advanced PAH. Risk factors for reduced bone density include SSC-PAH, reduced 6MWD, need for oxygen during 6MWD testing, reduced FEV1, a history of smoking or corticosteroid use, and postmenopausal status.
authors: Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA.
authors: Numaan
authors: N
authors: Malik
authors: Kevin
authors: K
authors: McCarthy
authors: Omar A
authors: OA
authors: Minai
mesh_terms: D000328:Adult; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology