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Bone mineral density and fractures in older men with chronic obstructive pulmonary disease or asthma
| Journal | Osteoporosis International |
| Publisher | Springer London |
| ISSN | 0937-941X (Print) 1433-2965 (Online) |
| Category | Original Article |
| DOI | 10.1007/s00198-009-1076-x |
| Subject Collection | Medicine |
| SpringerLink Date | Friday, October 09, 2009 |
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Original Article
Bone mineral density and fractures in older men with chronic obstructive pulmonary disease or asthma
T.-T. Dam1, 6  , S. Harrison2, H. A. Fink3, J. Ramsdell4, E. Barrett-Connor5 and for the Osteoporotic Fractures in Men (MrOS) Research Group
| (1) |
Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York, USA |
| (2) |
Research Institute, California Pacific Medical Center, San Francisco, California, USA |
| (3) |
Geriatric Research Education and Clinical Center and Center for Chronic Disease Outcomes Research, Veterans Affairs Medical
Center, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA |
| (4) |
Department of Medicine, School of Medicine, University of California San Diego, La Jolla, California, USA |
| (5) |
Department of Family and Preventive Medicine, School of Medicine, University of California San Diego, La Jolla, California, USA |
| (6) |
Columbia University, College of Physicians and Surgeons, 5141 Broadway, New York, New York 10035, USA |
Received: 22 September 2008 Accepted: 26 August 2009 Published online: 9 October 2009
Abstract
Summary In 5,541 community dwelling men, chronic obstructive pulmonary disease, or asthma was associated with lower bone mineral density
(BMD) at the spine and total hip and an increased risk of vertebral and nonvertebral fractures independent of age, body mass
index, and smoking. Men prescribed with corticosteroids had the lowest BMD.
Introduction It is unclear whether chronic obstructive pulmonary disease (COPD) is independently associated with BMD and fractures.
Methods In 5,541 men from the Osteoporotic Fractures in Men Study, history of COPD or asthma, current treatment with corticosteroids,
BMD, bone loss after 4.5 years and fractures were ascertained.
Results Seven hundred fourteen (13%) men reported COPD or asthma, of which 103 were prescribed an oral steroid and 177 an inhaled
steroid. Independent of confounders, men prescribed corticosteroids for COPD or asthma had the lowest BMD and a 2-fold increased
risk of vertebral osteoporosis compared to men with no history of COPD or asthma (OR 2.13, 95% CI (confidence interval) 1.15–3.93
oral steroids; OR 2.05, 95% CI 1.27–3.31 inhaled steroids). During follow-up, BMD increased at the spine, but there was no
difference in bone loss at the hip. However, men with COPD or asthma had a 2.6- and 1.4-fold increased risk of vertebral and
nonvertebral fractures, respectively.
Conclusion Chronic obstructive pulmonary disease or asthma was associated with lower BMD at the spine and hip and increased risk of vertebral
and nonvertebral fractures independent of age, clinic site, BMI, and smoking. A history of COPD or asthma may be a useful
clinical risk factor to identify patients with osteoporosis.
Keywords Bone loss - Bone mineral density - Elderly - Fractures - Pulmonary disease
References
| 1. |
Minino AM, Heron MP, Smith BL (2006) Deaths: preliminary data for 2004. Natl Vital Stat Rep 54:1–49
|
| |
| 2. |
Incalzi RA, Caradonna P, Ranieri P, Basso S, Fuso L, Pagano F, Ciappi G, Pistelli R (2000) Correlates of osteoporosis in chronic
obstructive pulmonary disease. Respir Med 94:1079–1084
|
| |
| 3. |
Iqbal F, Michaelson J, Thaler L, Rubin J, Roman J, Nanes MS (1999) Declining bone mass in men with chronic pulmonary disease:
contribution of glucocorticoid treatment, body mass index, and gonadal function. Chest 116:1616–1624
|
| |
| 4. |
Shane E, Silverberg SJ, Donovan D, Papadopoulos A, Staron RB, Addesso V, Jorgesen B, McGregor C, Schulman L (1996) Osteoporosis
in lung transplantation candidates with end-stage pulmonary disease. Am J Med 101:262–269
|
| |
| 5. |
Blank JB, Cawthon PM, Carrion-Petersen ML, Harper L, Johnson JP, Mitson E, Delay RR (2005) Overview of recruitment for the
osteoporotic fractures in men study (MrOS). Contemp Clin Trials 26:557–568
|
| |
| 6. |
Orwoll E, Blank JB, Barrett-Connor E, Cauley J, Cummings S, Ensrud K, Lewis C, Cawthon PM, Marcus R, Marshall LM, McGowan
J, Phipps K, Sherman S, Stefanick ML, Stone K (2005) Design and baseline characteristics of the osteoporotic fractures in
men (MrOS) study—a large observational study of the determinants of fracture in older men. Contemp Clin Trials 26:569–585
|
| |
| 7. |
Washburn RA, Ficker JL (1999) Physical Activity Scale for the Elderly (PASE): the relationship with activity measured by a
portable accelerometer. J Sports Med Phys Fitness 39:336–340
|
| |
| 8. |
Cummings SR, Bates D, Black DM (2002) Clinical use of bone densitometry: scientific review. JAMA 288:1889–1897
|
| |
| 9. |
Kanis JA (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of
a WHO report. WHO Study Group. Osteoporos Int 4:368–381
|
| |
| 10. |
Report of a WHO Study Group (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis.
World Health Organ Tech Rep Ser 843:1–129
|
| |
| 11. |
Looker AC, Johnston CC Jr, Wahner HW, Dunn WL, Calvo MS, Harris TB, Heyse SP, Lindsay RL (1995) Prevalence of low femoral
bone density in older U.S. women from NHANES III. J Bone Miner Res 10:796–802
|
| |
| 12. |
Sin DD, Man JP, Man SF (2003) The risk of osteoporosis in Caucasian men and women with obstructive airways disease. Am J Med
114:10–14
|
| |
| 13. |
Lekamwasam S, Trivedi DP, Khaw KT (2002) An association between respiratory function and bone mineral density in women from
the general community: a cross sectional study. Osteoporos Int 13:710–715
|
| |
| 14. |
Lekamwasam S, Trivedi DP, Khaw KT (2005) An association between respiratory function and hip bone mineral density in older
men: a cross-sectional study. Osteoporos Int 16:204–207
|
| |
| 15. |
Vestergaard P, Rejnmark L, Mosekilde L (2007) Fracture risk in patients with chronic lung diseases treated with bronchodilator
drugs and inhaled and oral corticosteroids. Chest 132:1599–1607
|
| |
| 16. |
Pujades-Rodriguez M, Smith CJ, Hubbard RB (2007) Inhaled corticosteroids and the risk of fracture in chronic obstructive pulmonary
disease. QJM 100:509–517
|
| |
| 17. |
Hubbard R, Tattersfield A, Smith C, West J, Smeeth L, Fletcher A (2006) Use of inhaled corticosteroids and the risk of fracture.
Chest 130:1082–1088
|
| |
| 18. |
Lukert BP, Raisz LG (1994) Glucocorticoid-induced osteoporosis. Rheum Dis Clin North Am 20:629–650
|
| |
| 19. |
Yoshikawa M, Kobayashi A, Yamamoto C, Fu A, Takenaka H, Ikuno M, Yoneda T, Narita N, Nezu K, Kitamura S (1997) Exercise performance
and body composition in patients with chronic obstructive pulmonary disease. Nihon Kyobu Shikkan Gakkai Zasshi 35:518–523
|
| |
| 20. |
Sin DD, Man SF (2006) Skeletal muscle weakness, reduced exercise tolerance, and COPD: is systemic inflammation the missing
link? Thorax 61:1–3
|
| |
| 21. |
Crook MA, Scott DA, Stapleton JA, Palmer RM, Wilson RF, Sutherland G (2000) Circulating concentrations of C-reactive protein
and total sialic acid in tobacco smokers remain unchanged following one year of validated smoking cessation. Eur J Clin Invest
30:861–865
|
| |
| 22. |
Dimai HP, Domej W, Leb G, Lau KH (2001) Bone loss in patients with untreated chronic obstructive pulmonary disease is mediated
by an increase in bone resorption associated with hypercapnia. J Bone Miner Res 16:2132–2141
|
| |
| 23. |
Carlson CL, Cushman M, Enright PL, Cauley JA, Newman AB (2001) Hormone replacement therapy is associated with higher FEV1
in elderly women. Am J Respir Crit Care Med 163:423–428
|
| |
|
|
|
|
|
|