title: Osteoporosis is highly prevalent in Japanese males with chronic obstructive pulmonary disease and is associated with deteriorated pulmonary function.
abstract: Osteoporosis has recently been recognized as a major comorbidity in chronic obstructive pulmonary disease (COPD). We conducted a cross-sectional study in a cohort of 136 Japanese males with COPD to evaluate the prevalence of vertebral fracture (VF) and to explore its relationship with pulmonary function parameters. VFs were present in 108 (79.4%); multiple and severe (SQ grade 2 or 3) VFs were found in 77 (56.6%) and 25 (18.4%), respectively. Multivariate logistic regression analyses revealed that decrease in forced expiratory volume in one second (FEV1.0)/forced vital capacity (FVC) [odds ratio (OR) 0.963, 95% confidence interval (CI) 0.929-998, p = 0.036] was associated with the presence of VF after adjustment for age and that FVC (OR 0.462, 95% CI 0.220-0.968, p = 0.041) and current smoking (OR 2.992, 95% CI 1.128-7.940, p = 0.028) were associated with VF severity (grade 2-3 vs. 1). We also found that FEV1.0 was the sole independent determinant of the number of VFs by stepwise multivariate linear regression (p < 0.001). Bone mineral density (BMD) values were available in 49 subjects. Mean T scores were -2.0 ± 1.2 in femoral neck, -1.4 ± 1.2 in total hip and -1.1 ± 1.4 in lumbar spine. Nineteen patients (38.8%) had a BMD T score less than -2.5. BMD Z scores of all the sites showed a progressive decrease as GOLD stage of COPD advanced (p < 0.05). Our results indicate a high prevalence of osteoporosis in Japanese male COPD patients and a strong inter-relationship between the two diseases, re-emphasizing the urgent need for appropriate intervention to maintain both bone and lung health.
authors.affiliation: Third Department of Medicine, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara, Chiba, 299-0111, Japan.
authors.forename: Reiko
authors.initials: R
authors.lastname: Watanabe
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tanaka
authors.forename: Keisuke
authors.initials: K
authors.lastname: Aita
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hagiya
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Homma
authors.forename: Kyoko
authors.initials: K
authors.lastname: Yokosuka
authors.forename: Hisami
authors.initials: H
authors.lastname: Yamakawa
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Yarita
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Tai
authors.forename: Junko
authors.initials: J
authors.lastname: Hirano
authors.forename: Daisuke
authors.initials: D
authors.lastname: Inoue
authors.forename: Ryo
authors.initials: R
authors.lastname: Okazaki
mesh_terms: D000368:Aged; D015519:Bone Density; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005541:Forced Expiratory Volume; D006801:Humans; D007564:Japan; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D008168:Lung / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010024:Osteoporosis / Q000150:complications / Q000453:epidemiology*; D058866:Osteoporotic Fractures / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000453:epidemiology*; D011859:Radiography; D015203:Reproducibility of Results; D012129:Respiratory Function Tests; D012907:Smoking; D016103:Spinal Fractures / Q000150:complications / Q000453:epidemiology*; D014797:Vital Capacity; D014965:X-Rays