Predictors of osteoporosis and vertebral fractures in patients presenting with moderate-to-severe chronic obstructive lung disease

Hiromi Ogura-Tomomatsu, Koichiro Asano, Katsuyoshi Tomomatsu, Jun Miyata, Nao Ohmori, Motohiro Kodama, Soichiro Ueda, Takahisa Takihara, Kyuto Tanaka, Nobufumi Kamiishi, Yusuke Suzuki, Koichi Fukunaga, Tsuyoshi Oguma, Koichi Sayama, Tomoko Betsuyaku

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Abstract

Bone mineral density (BMD) alone does not reliably predict osteoporotic fractures. The Fracture Risk Assessment Tool (FRAX) was developed to estimate the risk of fracture in the general population. This study was designed to identify predictors of osteoporosis and vertebral fractures in patients presenting with chronic obstructive pulmonary disease (COPD). We studied 85 patients (mean age = 75 years; 92% men) with moderate to very severe COPD. Osteoporosis and vertebral fractures were diagnosed with dual energy X-ray absorptiometric scan and vertebral X-rays, respectively. Patient characteristics, including age, gender, body mass index (BMI), and results of pulmonary function tests, chest computed tomography scan, blood and urinary biomarkers of bone turnover were recorded, and a FRAX score was calculated by a computer-based algorithm. Osteoporosis, defined as a T score < 2.5, found in 20 patients (24), was associated with female gender, BMI, dyspnea scale, long-term oxygen therapy (LTOT), vital capacity (VC), emphysema score on computed tomography, measurements of serum and urinary biomarkers of bone turnover. Vertebral fractures, diagnosed in 29 patients (35), were strongly correlated with age, LTOT, VC, and forced expiratory volume in 1 sec, treatment with oral corticosteroid or warfarin, and weakly associated with the presence of osteoporosis. There was no correlation between FRAX score and prevalence of vertebral fractures, suggesting that neither BMD alone nor FRAX score would predict the presence of vertebral fractures in COPD patients. A disease-specific algorithm to predict osteoporotic fractures is needed to improve the management of patients suffering from COPD.

Original languageEnglish
Pages (from-to)332-337
Number of pages6
JournalCOPD: Journal of Chronic Obstructive Pulmonary Disease
Volume9
Issue number4
DOIs
Publication statusPublished - 2012 Aug 1

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Keywords

  • Bone mineral density
  • Chronic respiratory failure
  • Corticosteroid
  • Fracture Risk Assessment Tool
  • Long-term oxygen therapy

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Ogura-Tomomatsu, H., Asano, K., Tomomatsu, K., Miyata, J., Ohmori, N., Kodama, M., Ueda, S., Takihara, T., Tanaka, K., Kamiishi, N., Suzuki, Y., Fukunaga, K., Oguma, T., Sayama, K., & Betsuyaku, T. (2012). Predictors of osteoporosis and vertebral fractures in patients presenting with moderate-to-severe chronic obstructive lung disease. COPD: Journal of Chronic Obstructive Pulmonary Disease, 9(4), 332-337. https://doi.org/10.3109/15412555.2012.667850