Risk factors for osteoporosis in male patients with chronic obstructive pulmonary disease in Taiwan.

Chu-Hsu Lin,Kai-Hua Chen,Chia-Hung Lin,Chien-Min Chen,Tung-Jung Huang,Chia-Hao Chang

doi:10.7717/peerj.4232

Abstract

ObjectiveTo investigate the risk factors for osteoporosis in male Taiwanese patients with chronic obstructive pulmonary disease (COPD).MethodsThis cross-sectional study evaluated male COPD outpatients and age-matched male subjects at a regional teaching hospital. The following data were obtained and analyzed: bone mineral density of the lumbar spine and hip on dual-energy X-ray absorptiometry, demographic characteristics, questionnaire interview results, pulmonary function test results, chest posterior–anterior radiographic findings, and biochemical and high-sensitivity C-reactive protein (hs-CRP) levels.ResultsFifty-nine male COPD patients and 36 age-matched male subjects were enrolled. COPD patients had lower body mass index (BMI) (23.6 ± 4.1 vs. 25.2 ± 3.0 kg/m2) and higher total prevalence for osteoporosis and osteopenia than controls. Among COPD patients, patients with osteoporosis had lower BMI, body weight, waist circumference, and triglyceride level but higher hs-CRP level, and tended to have lower creatinine level. Binary logistic regression analysis for factors including age, BMI, creatinine, hs-CRP, smoking, steroid use, and forced expiratory volume in one second (FEV1) revealed that an hs-CRP level ≥5 and decreased creatinine level were independent risk factors for osteoporosis in COPD patients. Lower BMI tended to be associated with osteoporosis development, although it did not reach statistical significance, and hs-CRP was associated with COPD severity and steroid use history.ConclusionThe total prevalence of osteoporosis and osteopenia in male Taiwanese COPD patients is higher than that in age-matched male subjects and systemic inflammation is an independent risk factors for osteoporosis. Low creatinine level in COPD patients should raise the suspicion of sarcopenia and associated increased risk of osteoporosis.

Highlights

Chronic obstructive pulmonary disease (COPD), a major global public health issue burdening health-care systems, is characterized by persistent and usually progressive airflow limitation resulting from chronic inflammation of the airways and lungs (Vestbo et al, 2013)
In multivariate binary logistic regression analysis showed that low body mass index (BMI) was the independent risk factors of increased prevalence of osteoporosis and osteopenia and the variable COPD (COPD patients versus controls) lost its statistical significance (Table 3)
The present study revealed that the prevalences of osteoporosis and osteopenia in COPD patients at a community hospital in Taiwan were 28.8% and 42.4%, respectively, and the total prevalence of them were higher than those in age-matched healthy controls, which was mainly contributed by low BMI in COPD patients

Summary

Introduction

Chronic obstructive pulmonary disease (COPD), a major global public health issue burdening health-care systems, is characterized by persistent and usually progressive airflow limitation resulting from chronic inflammation of the airways and lungs (Vestbo et al, 2013). The incidence and prevalence of COPD are much greater in men than in women worldwide (Afonso et al, 2011). It is regarded as a heterogeneous disease with many systemic manifestations and comorbidities, such as ischemic heart disease, heart failure, anemia, diabetes, skeletal muscle wasting, osteoporosis, and osteoporotic fracture (Barnes & Celli, 2009; Lee et al, 2016). Osteoporosis, an important comorbidity of COPD, increases the risk of fracture, with resultant pain, functional limitation, and increased mortality (Sambrook & Cooper, 2006). Early detection, prevention, and treatment of osteoporosis in COPD patients is important

Methods

Results

Conclusion