Assessment of Bone Mineral Density in Male Patients with Chronic Obstructive Pulmonary Disease by DXA and Quantitative Computed Tomography.

George Fountoulis,Marianna Vlychou,Konstantinos Gourgoulianis,Paschal Thriskos,Constantinos Kokkinis,Theodora Kerenidi,Ioannis Fezoulidis,Panagiotis Georgoulias,Katerina Vassiou

doi:10.1155/2016/6169721

Abstract

The purpose of this study is to identify the prevalence of osteoporosis in male patients with chronic obstructive pulmonary disease (COPD) by dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) and to compare the diagnostic abilities of the above methods. Thirty-seven male patients with established COPD were examined with DXA and standard QCT in lumbar spine, including L1, L2, and L3 vertebrae. T-scores and bone mineral density values were calculated by DXA and QCT method, respectively. Comparative assessment of the findings was performed and statistical analysis was applied. QCT measurements found more COPD patients with impaired bone mineral density compared to DXA, namely, 13 (35.1%) versus 12 (32.4%) patients with osteopenia and 16 (43.2%) versus 9 (16.2%) patients with osteoporosis (p = 0.04). More vertebrae were found with osteoporosis by QCT compared to DXA (p = 0.03). The prevalence of osteoporosis among male patients with COPD is increased and DXA may underestimate this risk. QCT measurements have an improved discriminating ability to identify low BMD compared to DXA measurements because QCT is able to overcome diagnostic pitfalls including aortic calcifications and degenerative spinal osteophytes.

Highlights

Chronic obstructive pulmonary disease (COPD) is a disease characterized by nonreversible airflow obstruction [1]
COPD patients have a greater prevalence of osteoporosis compared with normal subjects; this has been attributed to the systemic use of oral corticosteroids, to the use of tobacco, to systemic inflammation, and to less ability for exercise [5]
The prevalence of low bone mineral density (BMD) by quantitative computed tomography (QCT) in our patients was high; 37.8% of our patients were osteopenic and 43.2% were osteoporotic. These results are in accordance with a published meta-analysis, which has shown that, in COPD patients, there is a prevalence of osteoporosis of 35.1% and a prevalence of osteopenia of 38.4% [4]

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) is a disease characterized by nonreversible airflow obstruction [1]. A meta-analysis showed that the percentage of COPD patients with osteoporosis is approximately 35% and that osteoporosis’ prevalence is higher in women, in patients in a worse stage of COPD, and in patients with a low body-mass index [4]. COPD patients have a greater prevalence of osteoporosis compared with normal subjects; this has been attributed to the systemic use of oral corticosteroids, to the use of tobacco, to systemic inflammation, and to less ability for exercise [5]. The gold standard of measuring bone density is dualenergy X-ray absorptiometry (DXA). The technical drawbacks of this method are well acknowledged [7]; as DXA is a two-dimensional method of International Journal of Endocrinology assessing bone mineral density (BMD), superimposed tissue may cause artifacts and inaccurate measurements

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Conclusion