Abstract
The goals of this study were to determine whether bone density measured using CT (CTBD) can show significant differences in bone loss according to smoking status and pack-years, and to examine the correlation between CTBD and bone mineral density when measured by dual-energy X-ray absorptiometry (DEXA-BMD) in males without chronic obstructive pulmonary disease (COPD). In this cross-sectional study, 1,011 males without airflow obstruction ≥50 years old were included. CTBD and DEXA-BMD were compared among groups with different smoking statuses. The correlation between CTBD and DEXA-BMD and the association of CTBD with pack-years were also investigated. CTBD of all vertebral bodies (VBs) and DEXA-BMD of all VBs without L1 showed significant differences among never, former, and current smokers. CTBD was significantly lowest in ≥30-pack-year smokers and was significantly lower in ≥30-pack-year smokers than in <15-pack-year smokers (all P < 0.05). There were significant correlations between DEXA-BMD and CTBD at all VB levels (correlation coefficient [r], 0.448~0.640; all P < 0.01). A lower CTBD had a significant association with a 15 ≤ x < 30-pack-year smoking history and ≥30-pack-year smoking history, while there was no association with never-smokers. In conclusion, CTBD demonstrated significant differences in bone quality according to smoking status and pack-years in males without COPD.
Highlights
Smoking is a well-established risk factor that induces bone loss as a secondary cause of osteoporosis and increases the risk of fractures[1,2,3]
This study provided evidence that smoking is associated with decreased bone density measured by chest CT in male subjects ≥50 years old without chronic obstructive pulmonary disease (COPD)
Lower bone density on CT was significantly associated with more pack-years
Summary
Smoking is a well-established risk factor that induces bone loss as a secondary cause of osteoporosis and increases the risk of fractures[1,2,3]. Several recent studies have shown that bone density measured on CT (CTBD) is valuable for early detection of osteoporosis; it showed good correlation with bone mineral density measured by DEXA (DEXA-BMD) and good diagnostic performance for identifying bone fragility[4,5,6,7]. There have been several studies investigating the relationship between smoking and bone mineral loss using CTBD. Lower values of CTBD were found in current smokers compared to former smokers[10] These studies were performed in COPD patients or in a general population that included COPD patients. It is important to investigate the relationship between smoking and CTBD in a normal population without COPD, and no study has been published on this topic yet. The purpose of this study was to determine whether CTBD can show significant differences in bone quality according to smoking status and pack-years, and to examine the correlation between CTBD and DEXA-BMD in males ≥50 years old without COPD
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