Patients with Chronic Obstructive Pulmonary Disease Have a High Prevalence of Osteopenia and Osteoporosis associated with the Worst Degrees of Pulmonary Function and Prognosis

Abstract

Introduction/Background: Chronic obstructive pulmonary disease (COPD) is associated with osteoporosis and vertebral fractures. It is still unclear whether the presence of fractures and changes in bone mineral density (BMD) are associated with disease severity and prognosis. The aim of this study was to evaluate low BMD, and morphometric vertebral fractures (MVF) in patients with COPD compared with two control groups and correlate these parameters with indices of COPD severity (FEV1 and GOLD) and prognosis (BODE). Methodology: This was a cross-sectional study in COPD patients (disease group, DG) that undergone BMD and vertebral fracture assessment (VFA). Two control groups were used, one group of smokers individuals without COPD (smokers group, SG), and another group of healthy never smokers individuals (never smokers group, NSG). Results: DG comprised 121 patients (65 women, mean age 67.9 ± 8.6 years). Altered BMD was observed in 88.4% of the patients in the DG which was more prevalent when compared to control groups (p<0.001). The BMD values were lower in the DG than in controls (p<0.05). BMD was associated with the worst degree of obstruction (FEV1), GOLD, and BODE (p<0.05). The prevalence of MVF was high (57.8%) and greater than that in the SG (23.8%), and NSG (14.8%; p<0.001). The prevalence of fractures was not associated with FEV1, GOLD, or BODE. Conclusions: This study showed a high prevalence of low BMD in COPD patients and an association with a worse degree of FEV1, GOLD, and BODE. MVF in patients with COPD were also higher but were not associated with disease gravity and prognosis.