title: Chronic obstructive pulmonary disease and low bone mass: A case-control study.
abstract: OBJECTIVE
  Low bone mass (osteopenia and osteoporosis) is one of the effects associated with chronic obstructive pulmonary disease (COPD). There is very little data from Saudi Arabia on COPD and low bone mass. This retrospective study was done to assess the prevalence of osteoporosis and osteopenia in COPD patients attending King Fahd Hospital of the University (KFHU), Alkhobar.
  
  
  METHODS
  After obtaining the ethical approval from the research committee, all patients seen between at the King Fahd Hospital of the University between January 2010 and December 2012 were included. The inclusion criteria included a follow up of a minimum 2 years, and the Medical Records should have the details of forced expiratory volume in one second (FEV1), blood bone profile and bone biomarkers and dual-energy X-ray absorptiometry (DEXA) scan. Patients were labeled as osteopenia if the T score was -<1 to <-2.5 and osteoporosis of <-2.5 as per the WHO definition of osteopenia and osteoporosis.
  
  
  RESULTS
  Seventy-three patients were being followed in the clinics and 49 patients satisfied the inclusion criteria. The average age was 60.6 ± 10.47 years; males were 43 and females 6. Three (6.1%) were normal and the remaining 46 (93.9%) were with low bone mass. Thirty-two (65.3%) were osteoporotic and 14 (28.57%) were osteopenic. The average duration of COPD was 4.5 ± 6.2 years. Majority (n = 36, 73.4%) of patients were in the Global Initiative for COPD (GOLD) class II and III. FEV1 was significantly lower in the patients with low bone mass 1.66 ± 0.60 versus 3.61 ± 0.58 (P < 0.001).
  
  
  CONCLUSIONS
  Our study shows that over 90% of Saudi Arabian patients with COPD suffer from osteopenia and osteoporosis and unfortunately they remain under-diagnosed and undertreated.
authors.affiliation: Department of Pulmonology and Critical Care, Metro Group of Hospitals, New Delhi, India.
authors.forename: Rakesh K
authors.initials: RK
authors.lastname: Gupta
authors.affiliation: Department of Endocrine, College of Medicine, University of Dammam and King Fahd Hospital of the University, AlKhobar, Saudi Arabia.
authors.forename: Syed E
authors.initials: SE
authors.lastname: Ahmed
authors.affiliation: Department of Endocrine, College of Medicine, University of Dammam and King Fahd Hospital of the University, AlKhobar, Saudi Arabia.
authors.forename: Abdulmohsen H
authors.initials: AH
authors.lastname: Al-Elq
authors.affiliation: Department of Orthopaedic Surgery, College of Medicine, University of Dammam and King Fahd Hospital of the University, AlKhobar, Saudi Arabia.
authors.forename: Mir
authors.initials: M
authors.lastname: Sadat-Ali
keywords: Chronic obstructive pulmonary disease; osteopenia; osteoporosis; secondary osteoporosis