Predictive and modifying factors of bone mineral density decline in patients with COPD. (March 2019)

• Record Type: Journal Article
• Authors: Kameyama, Naofumi; Chubachi, Shotaro; Sasaki, Mamoru; Tsutsumi, Akihiro; Irie, Hidehiro; Sakurai, Kaori; Sayama, Koichi; Nakamura, Hidetoshi; Asano, Koichiro; Betsuyaku, Tomoko; Fukunaga, Koichi
• Is Part Of: Respiratory medicine. Volume 148(2019)
• Page Start: 13
• Page End: 23
• Publication Date: 2019-03
• Subjects: COPD -- Comorbidity -- Osteoporosis -- Vertebral fracture -- Bisphosphonate; COPD chronic obstructive pulmonary disease -- QOL quality of life -- BMI body-mass index -- BMD bone mineral density -- ICS inhaled corticosteroid -- SD standard deviation -- K-CCR Keio Chronic Obstructive Pulmonary Disease Comorbidity Research -- WHO World Health Organization -- SGRQ St. George's Respiratory Questionnaire -- SF-36 Short Form 36 Health Survey -- CT computed tomography -- LAA% ratio of low attenuation are to total lung volume -- DXA Dual-energy X-ray Absorptiometry -- IQR interquartile range -- GOLD Global Initiative for Chronic Obstructive Lung Disease -- OCS oral corticosteroid -- FEV1 forced expiratory volume in 1 s -- %FEV1 forced expiratory volume in 1 s as a percentage of predicted value -- DLCO/VA diffusing capacity of the lung for carbon monoxide divided by alveolar volume -- %DLCO/VA diffusing capacity of the lung for carbon monoxide divided by alveolar volume as a percentage of predicted value; Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2019.01.005
• Languages: English
• ISSNs: 0954-6111

Abstract

Abstract: Rationale: Various determinants of osteoporosis have been previously identified. However, only a few longitudinal studies have examined related factors. We aimed to investigate factors predicting and modifying rapid decline of bone mineral density in patients with chronic obstructive pulmonary disease. Methods: We analyzed patients with chronic obstructive pulmonary disease whose bone mineral density were measured at least three times over three years (n = 111). We divided annual per cent changes of bone mineral density in different body parts into tertiles. Rapid decliners (n = 33) were defined as those with the largest decline in at least two parts; all other participants were defined as non-rapid decliners (n = 78). Results: At enrollment, bone mineral density did not differ between the two groups. However, rapid decliners had a significantly greater rate of new vertebral fractures over 3 years compared with non-rapid decliners. On multivariate logistic regression analysis, age, moderate to severe emphysema, no daily exercise habits, and anemia increased the likelihood of rapid decliners. Furthermore, patients who newly started and continued bisphosphonate exhibited higher annual per cent changes of bone mineral density than did those without bisphosphonate use. Conclusions: A rapid decline in bone mineral density correlates to a higher likelihood of vertebral fracture. We clarified the predictors of bone mineral density decline and demonstrated that bisphosphonate use might modify bone mineral density in patients with chronic obstructive pulmonary disease. Highlights: Factors predicting and modifying rapid decline of bone mineral density in COPD patients were investigated. Rapid decliners had a significantly greater rate of new vertebral fractures. Age, emphysema, no daily exercise habits, and anemia increased the likelihood of rapid decliners. Bisphosphonate had positive effect on BMD decline over 3 years.