COPD tied to low BMD and high risk of vertebral fractures, finds study

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory airway disease associated with various systemic comorbidities including osteoporosis. Recent studies have suggested that both decreased bone mineral density (BMD) and impaired bone quality contribute to bone fragility, causing fractures in COPD patients.

Various clinical risk factors of osteoporosis in COPD patients, including older age, emaciation, physical inactivity, and vitamin D deficiency, have also been described.

Recently a study was undertaken to evaluate the association between osteoporosis and vertebral fragility fractures with cardiovascular calcification in patients with COPD.

The study population consisted of A total of 97 patients who underwent BMD and body composition analyses via dual-energy x-ray absorptiometry, spirometric evaluation, and laboratory tests. Vertebral fractures were assessed with a conventional x-ray of the thoracic and lumbar spine using semiquantitative Genant's criteria and vascular calcification of abdominal aorta using Kauppila's method.

On data analysis, the following results emerged.

• In the sample,44 were men (mean age, 65.8 years) and 52 were women (mean age, 64.3 years) with mean Kauppila's index of 4.8.
• A Kauppila's index ≥7 vs <7 was associated with older age (67.9 vs 63.5 years, respectively; P <.05), lower femoral neck BMD (0.784 vs 0.877 g/cm2, respectively; P <.05), and higher serum creatinine (1.0 vs 0.8 mg/dL, respectively; P <.05).
• Also, more vertebral fractures (Genant's grades 2 and 3) were seen in patients with Kauppila's index ≥7 vs those with Kauppila's index <7 (33.3% vs 17.5%; respectively, P =.07).
• The team further observed that age and low femoral neck BMD in women, and age and high body fat in men were the main factors contributing to a Kauppila's index ≥7.

It is critically important for pulmonologists to be aware of the high prevalence of vertebral fractures in COPD patients and evaluate them for such fracture risks. Routine screening will enable physicians to diagnose COPD patients with low BMD at an early stage and give them appropriate treatment to prevent fracture, which may lead to improved quality of life as well as better long-term prognosis.

For the full article click on the link: Grauman R. Lower femoral neck bone mineral density and higher body fat are associated with vascular calcification in chronic obstructive pulmonary disease patients. Presented at: ASBMR 2020 Virtual Annual Meeting; September 11-15, 2020. Poster #P-018.

Primary source: American Society for Bone and Mineral Research (ASBMR) 2020 Annual Meeting