title: Are asthmatic patients prone to bone loss?
abstract: BACKGROUND
  Recent studies suggest an association between allergic diseases, including asthma, and lower vitamin D level, a well-known risk factor of osteoporosis. However, it is not yet clearly known whether patients with asthma are prone to bone loss.
  
  
  OBJECTIVE
  To evaluate whether the occurrence of airway hyperresponsiveness (AHR) or asthma is related to significant changes in bone mineral density (BMD).
  
  
  METHODS
  We retrospectively enrolled 7,034 patients who had undergone a health checkup program, including BMD tests and methacholine bronchial challenge tests, at the Seoul National University Hospital, Healthcare System Gangnam Center, from November 1, 2004 to April 30, 2011. Asthma was ascertained by self-reported medical diagnosis by a physician. Patients with a history of systemic corticosteroid medication use were excluded from the study.
  
  
  RESULTS
  Among a total of 7,034 patients, 216 (3.1%) had a positive AHR test result, and 217 (3.1%) had a history of asthma. Lumbar spine and femur BMD of patients with AHR were significantly lower than those without AHR (-0.53 ± 1.50 vs -0.03 ± 1.49, -0.47 ± 0.97 vs -0.22 ± 0.99, respectively; P < .001 for both). After being adjusted for age, sex, body mass index, smoking status, postmenopausal state, and previous history of hormone replacement therapy, the proportion of patients with osteopenia or osteoporosis was much higher in the AHR-positive group than in the AHR-negative group (odds ratio, 1.715; 95% confidence interval, 1.252-2.349) and in the ever-asthma group than in the never-asthma group (odds ratio, 1.526; 95% confidence interval, 1.120-2.079).
  
  
  CONCLUSIONS
  In the current study, AHR and asthma were related to clinically meaningful BMD decrease, although the causal relationship is unclear.
authors.affiliation: Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea; Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Jae-Woo
authors.initials: JW
authors.lastname: Jung
authors.affiliation: Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hye-Ryun
authors.initials: HR
authors.lastname: Kang
authors.affiliation: Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Ju-Young
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Seoul National University Hospital, Healthcare System Gangnam Center, Seoul, Korea.
authors.forename: So-Hee
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Seoul National University Hospital, Healthcare System Gangnam Center, Seoul, Korea.
authors.forename: Sun Sin
authors.initials: SS
authors.lastname: Kim
authors.affiliation: Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Seoul National University Hospital, Healthcare System Gangnam Center, Seoul, Korea. Electronic address: shcho@snu.ac.kr.
authors.forename: Sang Heon
authors.initials: SH
authors.lastname: Cho
mesh_terms: D001249:Asthma / Q000453:epidemiology*; D015992:Body Mass Index; D015519:Bone Density; D001862:Bone Resorption / Q000000981:diagnostic imaging / Q000453:epidemiology*; D001985:Bronchial Provocation Tests; D003430:Cross-Sectional Studies; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000502:physiology; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000502:physiology; D008297:Male; D016210:Methacholine Chloride; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology*; D011859:Radiography; D012189:Retrospective Studies
chemical_list: D016210:Methacholine Chloride