Title: Occurrence of Osteoporosis in COPD Patients- A Comparative Study with Age & Sex Matched Control
Authors: Dr Fatima Mamnoon, Dr Abhijeet Khandelwal, Dr Pralhad Prabhudesai
DOI: https://dx.doi.org/10.18535/jmscr/v5i8.111
Abstract
Introduction: Chronic Obstructive Pulmonary Disease (COPD) has been found to be associated with a variety of systemic manifestations and reduced bone mineral density being one of them. Due to scarcity of available Indian data, there is a need to evaluate the problem of osteoporosis in Indian population.
Methods: This prospective observational study was conducted with the objectives of studying the occurrence of osteoporosis in COPD patients as compared to age-sex matched controls and to assess the co-relation of osteoporosis with the severity of COPD.60 COPD (35 males & 25 females) cases, age & sex matched 60 control were classified. GOLD criteria 2013 was used to grade severity. Detailed clinical history & examination, blood investigations, spirometry & DEXA for bone density measurement was done.
Results: Among 60COPD patients, 37 had osteoporosis (40.5% females, 59.45% males), 22 had osteopenia. As apposed, only 11.6%&68.3% control group patients had osteoporosis & osteopenia respectively. We found Lumbar spine osteoporosis to be more common. 22.2%moderate, 96% severe & 85.7%very severe COPD patients had osteoporosis, which was statistically significant.
Conclusion: COPD patients are at a greater risk for osteoporosis when compared to age-sex matched control group patients. This risk increased with the severity of COPD.
Keywords: COPD, Osteoporosis, spirometry, DEXA.
References
- Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2013 Available from: Global Initiative for Chronic Obstructive lung Disease (GOLD), Web site: www.goldcopd.org/uploads/users/files/GOLD_Report_2013_Feb20.pdf
- World Health Organization. Burden of COPD. Available from: http://www.who.int/respiratory/copd/burden/en/index.html
- Papaioannou A, Parkinson W, FerkoN,et al (2003) Prevalence of vertebral fractures among patients with chronic obstructive pulmonary disease in Canada. OsteoporosInt 2003; 14(11):913–917.
- Jorgensen NR, Schwarz P, HolmeI.The prevalence of osteoporosis in patients with chronic obstructive pulmonary disease-A cross sectional study. Respir Med 2007; 101 (1):177-85.
- Graat-Verboom L, E.F.M Wouters, F.M.J.M Smeenk, et al. Current status of research on osteoporosis in COPD: a systemic review. EurRespir J 2009; 341:209-18
- Walsh LJ, Wong CA, Oborne J, et al. Adverse effects of oral corticosteroids in relation to dose in patients with lung disease. Thorax 2001; 56:279–84.
- Praet JP, Peretz A, Rozenberg S. Risk of osteoporosis in men with chronic bronchitis. OsteoporosInt 1992; 2:257–61.
- Burge PS, Calverley PM, Jones PW. Randomised, double blind, placebo controlled study of fluticasone propionate in patients with moderate to severe chronic obstructive pulmonary disease: the ISOLDE trial. Br Med J 2000; 320:1297–303.
- Richy F, Bousquet J, et al. Inhaled corticosteroids effects on bone in asthmatic and COPD patients: a quantitative systematic review. OsteoporosInt 2003; 14(3):179-190.
- Sin DD, Leung R, Gan WQ, Man SP. Circulating surfactant protein D as a potential lung-specific biomarker of health outcomes in COPD: A pilot study. BMC Pulm Med. 2007; 7:13.
- Vaquero-Barrios JM, Arenas-de Larriva MS, Redel-Montero J, et al.Bone mineral density in patients with chronic obstructive pulmonary disease who are candidates for lung transplant.Transplant Proc.. 2010 Oct;42(8):3020-2.
- WHO Scientific Group on the Prevention and management of osteoporosis: report of a WHO scientific group, 2007.