Assessment of Osteoporosis and Osteopenia and its Co-Relation with Disease Severity in Patients of Chronic Obstructive Pulmonary Disease with Respect to Associated Risk Factors: A Case Control Study in India

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) is the major cause of morbidity and mortality which results in an economic and social burden. Osteoporosis is considered as one of the major systemic manifestations of COPD. Aim and Objective: It is to determine the prevalence of osteoporosis in COPD patients and its disease severity and also to evaluate various risk factors involved in reduced bone mineral density in patients with COPD. Methods: A total of 30 COPD patients and 15 healthy controls were enrolled and all individuals were subjected to pulmonary function test and DEXA scan. Various risk factors for COPD associated with osteoporosis and association of osteoporosis with severity of COPD were studied and analyzed. Statistical analysis was done for parametric data using t-test. p value <0.05 was considered as significant.Results: The incidence of osteoporosis was found to be significantly higher in COPD patients (60%) compared to healthy adults (20%) (p=0.017). Osteoporosis within the COPD patients of age group of 51-60 was found to be significantly higher compared to other age group in COPD. Obesity, overweight and smoking habit as well as exacerbations may be the risk factors in COPD patients. The average number of exacerbation in COPD patients was 2.13. COPD Patients in Gold Stage 2 had less osteoporosis while majority of patients in stage 3 and stage 4 had osteoporosis. T score and BMD differed significantly between the cases and control (p=0.007). BMD was higher in healthy controls compared to COPD patients (p=0.012). BMD has higher in age group of 41-50 compared to age group 51-60. (p=0.021).Conclusion: The risk of osteoporosis and osteopenia increases with the increase of COPD severity. There are multiple risk factors which are found to be associated with osteoporosis and osteopenia in COPD. Thus the present study warrants further COPD study.