The Relationship of Bone Mineral Density in Men with Chronic Obstructive Pulmonary Disease Classified According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Combined Chronic Obstructive Pulmonary Disease (COPD) Assessment System

• Published in: Internal Medicine Vol. 56; no. 14; pp. 1781 - 1790
• Main Authors: Sakurai-Iesato, Yoriko, Kawata, Naoko, Tada, Yuji, Iesato, Ken, Matsuura, Yukiko, Yahaba, Misuzu, Suzuki, Toshio, Ikari, Jun, Yanagawa, Noriyuki, Kasahara, Yasunori, West, James, Tatsumi, Koichiro
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.01.2017; Japan Science and Technology Agency
• Subjects: Absorptiometry, Photon; Aged; Air flow; Asian People; Bone Density; Bone mineral density; bone mineral density (BMD); Chronic obstructive pulmonary disease; combined COPD assessment system; Computed tomography; COPD assessment test (CAT); Cross-Sectional Studies; Dual energy X-ray absorptiometry; dual-energy X-ray absorptiometry (DEXA); Humans; Internal medicine; Lung diseases; Male; Middle Aged; Obstructive lung disease; Original; Osteopenia; Osteoporosis; Osteoporosis - etiology; Osteoporosis - physiopathology; Pulmonary Disease, Chronic Obstructive - complications; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary functions; Quality of life; Respiratory function; Surveys and Questionnaires; combined COPD assessment system; bone mineral density (BMD); COPD assessment test (CAT); dual-energy X-ray absorptiometry (DEXA)
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.56.6910

Objective Osteoporosis, which is now recognized as a major comorbidity of chronic obstructive pulmonary disease (COPD), must be diagnosed by appropriate methods. The aims of this study were to clarify the relationships between bone mineral density (BMD) and COPD-related clinical variables and to explore the association of BMD with the updated Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification in men. Methods We enrolled 50 Japanese men with clinically stable COPD who underwent dual-energy X-ray absorptiometry (DEXA), pulmonary function testing, and computerized tomography (CT) and who had completed a questionnaire (COPD assessment test [CAT]). We determined the association between the T-score and other tested parameters and compared the BMD of patients in each GOLD category. Results Twenty-three of the 50 patients (46.0%) were diagnosed with osteopenia, and 7 (14.0%) were diagnosed with osteoporosis. The BMD findings were significantly correlated with the CAT score, forced expiratory volume in 1 second percentage predicted (FEV1% predicted), low attenuation volume percentage (LAV%), and percentage of cross-sectional area of small pulmonary vessels (%CSA) on CT images. Notably, the median T-score of the GOLD category D participants was significantly lower than that of the participants in each of the other categories (A [-0.98], B [-1.06], C [-1.05], and D [-2.19], p<0.05). Conclusion Reduced BMD was associated with airflow limitation, extent of radiographic findings, and a poor quality of life (QOL) in patients with COPD. The BMD of GOLD category D patients was the lowest of all of the patients evaluated, and category D patients may benefit from active intervention for osteoporosis.