title: Prevalence, risk factors, and health-related quality of life of osteoporosis in patients with COPD at a community hospital in Taiwan.
abstract: BACKGROUND
  Data regarding osteoporosis in COPD patients in Taiwan remain limited. The primary end point of this study was to evaluate the prevalence and risk factors of osteoporosis in COPD patients in Taiwan. The secondary end point was to examine the association between osteoporosis and health-related quality of life (HRQL) in COPD patients.
  
  
  METHODS
  This prospective cross-sectional study enrolled 125 COPD patients (mean age 73.6 years, forced expiratory volume in 1 second [FEV1] 1.19±0.43 L) who had bone mineral-density measurements performed consecutively. Demographic data, lung function, and HRQL including modified Medical Research Council dyspnea scale, St George's Respiratory Questionnaire, oxygen-cost diagram, Center for Epidemiologic Studies - depression scale, and COPD Assessment Test scores were recorded.
  
  
  RESULTS
  A total of 50 (40%) participants were diagnosed as having osteoporosis. In a multivariate logistic regression model including age, smoking amount (pack-year), body mass index (BMI), and FEV1, only BMI (odds ratio 0.824, 95% confidence interval 0.73-0.93; P=0.002) and FEV1 (odds ratio 0.360, 95% confidence interval 0.13-0.98; P=0.046) were negatively associated with an increased risk of osteoporosis in COPD patients. In addition, COPD patients with osteoporosis had significantly higher modified Medical Research Council dyspnea scale scores (1.7±0.8 vs 1.4±0.8, P=0.046), St George's Respiratory Questionnaire scores (36.6 vs 28.0, P=0.01), and COPD Assessment Test scores (14.7±8 vs 11.5±7, P=0.019), and lower oxygen-cost diagram score (4.8±1.8 vs 5.4±1.6, P=0.045) than patients without osteoporosis.
  
  
  CONCLUSIONS
  The prevalence of osteoporosis in COPD patients was high at a community hospital in Taiwan. BMI and FEV1 were the independent risk factors for osteoporosis in COPD. In addition, COPD patients with osteoporosis had worse HRQL than those without osteoporosis.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Chia-Yi Christian Hospital, Chia-Yim, Taiwan ; Division of Chest, Division of Pulmonary Medicine, Kuang Tien General Hospital, Taichung, Taiwan.
authors.forename: Chun-Wei
authors.initials: CW
authors.lastname: Lin
authors.affiliation: Department of Internal Medicine, Chia-Yi Christian Hospital, Chiayi, Taiwan.
authors.forename: Yih-Yuan
authors.initials: YY
authors.lastname: Chen
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Chia-Yi Christian Hospital, Chia-Yim, Taiwan ; Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi, Taiwan.
authors.forename: Yi-Jen
authors.initials: YJ
authors.lastname: Chen
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Chia-Yi Christian Hospital, Chia-Yim, Taiwan.
authors.forename: Chi-Yen
authors.initials: CY
authors.lastname: Liang
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Chia-Yi Christian Hospital, Chia-Yim, Taiwan ; Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi, Taiwan.
authors.forename: Ming-Shian
authors.initials: MS
authors.lastname: Lin
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Chia-Yi Christian Hospital, Chia-Yim, Taiwan ; College of Nursing, Dayeh University, Taichung, Taiwan ; Department of Respiratory Therapy, China Medical University, Taichung, Taiwan.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
mesh_terms: D015502:Absorptiometry, Photon; D015992:Body Mass Index; D015519:Bone Density; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005541:Forced Expiratory Volume; D006764:Hospitals, Community; D006801:Humans; D016015:Logistic Models; D008168:Lung / Q000503:physiopathology; D015999:Multivariate Analysis; D016017:Odds Ratio; D010024:Osteoporosis / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D011788:Quality of Life; D012307:Risk Factors; D013147:Spirometry; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology; D014797:Vital Capacity
keywords: bone density; chronic obstructive pulmonary disease; osteoporosis