Elsevier

Respiratory Medicine

Volume 94, Issue 11, November 2000, Pages 1079-1084
Respiratory Medicine

Regular Article
Correlates of osteoporosis in chronic obstructive pulmonary disease

https://doi.org/10.1053/rmed.2000.0916Get rights and content
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Abstract

The aim of this study was to analyse the correlates of reduced bone mineral density in patients with chronic obstructive pulmonary disease (COPD), with special regard to a possible protective role of hypercapnia.

One hundred and four consecutive COPD inpatients in stabilized respiratory conditions underwent a comprehensive assessment of their health status. Bone mineral density was measured by X-ray absorptiometry at the lumbar site and at the femoral neck site. Differences in health-related variables between patients with (group O, n=62) and without (group N, n=42) lumbar and/or femoral neck osteoporosis were assessed first by univariate analysis and then by logistic regression analysis aimed to identify independent correlates of osteoporosis.

Group O was characterized by worse nutritional status, as reflected by indices exploring either lean or fat mass, and by a trend towards lower forced expiratory volume in 1 sec/forced vital capacity ratio. Arterial tension of carbon dioxide lacked any correlation with bone mineral density. According to the logistic regression analysis, body mass index ≤22 kg m−2qualified as the only and positive independent correlate of osteoporosis (odds ratio=4·18; 95% confidence intervals=1·19–14·71).

In conclusion, malnutrition characterizes COPD patients with osteoporosis, while mild to moderate hypercapnia lacks either a positive or negative effect on bone mineral density. Longitudinal studies are needed to identify predictors rather than correlates of bone mineral density.

Keywords

osteoporosis
nutritional status
hypercapnia
chronic obstructive pulmonary disease.

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Correspondence should be addressed to: Leonello Fuso, MD, Fisiopatologia Respiratoria, Universita Cattolica S. Cuore, Largo A. Gemelli 8, 00168 Roma, Italy. Fax: +39 06 3051343.