Prevalence, predictors, dynamic bone change, and treatment efficacy of osteoporosis among chronic obstructive pulmonary disease patients: a prospective cohort study

Frontiers in Medicine

Medicine

Nicha Chantamanee¹  Piyaporn Srikaew¹  Sarayut Lucien Geater²  Warangkana Keeratichananont²  Punchalee Kaenmuang² 

[1] Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand;Respiratory and Respiratory Critical Care Medicine Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand;

关键词: chronic obstructive pulmonary disease (COPD);    osteoporosis;    bone mineral density (BMD);    bisphosphonate;    alendronate;   

DOI  :  10.3389/fmed.2023.1214277

 received in 2023-04-29, accepted in 2023-07-24,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundOsteoporosis is a silent chronic obstructive pulmonary disease (COPD) comorbidity that is often under-detected. We aimed to study the prevalence and potential predictors of osteoporosis in COPD. Dynamic changes in bone mass density (BMD) and treatment efficacy of bisphosphonate were also assessed.MethodsThis prospective cohort study included COPD patients between January 2017 and January 2019. Demographics data, spirometric parameters, and C-reactive protein (CRP) were collected. Bone mineral density (BMD) at the lumbar spine (L2-4) and both femoral necks were measured after enrollment and the 12-month follow-up. Participants were categorized into three groups per the baseline BMD T-score: normal (≥ − 1.0), osteopenia (between −1.0 and − 2.5), and osteoporosis (≤ − 2.5). In the osteoporosis group, alendronate 70 mg/week with vitamin D and calcium was prescribed.ResultsIn total, 108 COPD patients were enrolled. The prevalence of osteoporosis and osteopenia were 31.5 and 32.4%, respectively. Advanced age, lower body mass index (BMI), history of exacerbation in the previous year, and high CRP levels were significant predictors of osteoporosis. After 12 months, 35.3% in the osteoporosis group reported new vertebral and femoral fractures, compared to none in the non-osteoporosis group (p < 0.001). In the normal BMD and osteopenia groups showed a further decline in BMD after 12-month. Conversely, the osteoporosis group showed a statistically significant improvement in BMD after anti-resorptive treatment (p < 0.001).ConclusionThe prevalence of osteoporosis was high in Thai COPD patients. Advanced age, lower BMI, history of exacerbation, and high CRP levels were potential predictors. A rapid decline in BMD was observed in COPD patients without treatment.

【 授权许可】

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Copyright © 2023 Kaenmuang, Keeratichananont, Geater, Chantamanee and Srikaew.