Relationship between osteoporosis and chronic obstructive pulmonary disease in elderly male patients_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

CHEN Hong ¹ ,  LI Weiming ²

Cadre Wards，Sichuan Provincial Peoples Hospital.Chengdu，Sichuan，610072，ChinaCorresponding author：LI Wei-min，E-mail：weimin003@yahoo.com;

Corresponding author：

LI Weiming, Email: weimin003@yahoo.com

Keywords：

Chronic obstructive pulmonary disease; Bone mineral density; Osteocalci

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ObjectiveTo evaluate the incidence of osteoporosis and relevant factors in the elderly male patients with chronic obstructive pulmonary disease(COPD).Methods Forty elderly male patients with COPD were enrolled and thirty age-matched healthy subjectss were enrolled.The BMD of lumbar vertebrae and proximal end of the femur were measured by dual energy X-ray absorptiometry.Serum levels of osteocalcin （BGP）and lung function were measured while blood-gas analysis of arterial blood was conducted.Results The BMD of lumbar vertebrae and proximal end of the femur(including lumbar 1 to 4，femoral neck，wards triangle，trochanter and shaft) in the COPD group were significantly lower than those in the control subjects(all P lt;0.01).Serum BGP level in the COPD group was higher than that in the control group[(5.67±1.59)ng/mL vs (4.37±1.47)ng/mL，P lt;0.01).The prevalence of osteoporosis among the COPD patients was significantly higher than that among the control subjects（65% vs 40%，50% vs 20%，both P lt;0.05）.BMD in the COPD patients who had a history of smoking was significantly lower than those who did not smoke cigarettes（P lt;0.01 or P lt;0.05）.BMD in the COPD patients treated with glucocorticoid were significantly lower than those who were not receiving glucocorticoid therapy(P lt;0.01 or P lt;0.05).BMD was positively correlated with PaO2，BMI，FEV1%pred and FEV1/FVC(P lt;0.01 or P lt;0.05).Conclusions Compared with age-matched normal controls，BMD in elderly male COPD patients are significantly lower with increased osteoporosis risk.Osteoporosis induced by COPD is high change-over pattern. BMD in patients with COPD may be correlated with hypoxia，lung function，smoking，low body mass index and glucocorticoids therapy.

Citation： CHEN Hong,LI Weiming. Relationship between osteoporosis and chronic obstructive pulmonary disease in elderly male patients. Chinese Journal of Respiratory and Critical Care Medicine, 2008, 08(4): 263-267. doi: Copy

1.	Spurzem JR，Rennard SI.Pathogenesis of COPD.Semin Respir Crit Care Med，2005，26：142-153.
2.	Jørgensen NR，Schwarz P，Holme I，et al.The prevalence of osteoporosis in patients with chronic obstructive pulmonary disease：a cross sectional study.Respir Med，2007，101：177-185.
3.	中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南.中华内科杂志，2002，41：640-646.
4.	Bolton CE，Ionescu AA，Shiels KM，et al.Associated loss of fat-free mass and bone mineral density in chronic obstructive pulmonary disease.Am J Respir Crit Care Med，2004，170：1286-1293.
5.	Balasubramanian VP，Varkey B.Chronic obstructive pulmonary disease：effects beyond the lungs.Curr Opin Pulm Med，2006，12：106-112.
6.	Papaioannou A，Parkinson W，Ferko N，et al.Prevalence of vertebral fractures among patients with chronic obstructive pulmonary disease in Canada.Osteoporos Int，2003，14：913-917.
7.	李斯南.43例慢性阻塞性肺病患者骨密度和骨代谢的改变.医药论坛杂志，2003，24：27-28.
8.	郭素华,杨定焯,许志奇,等.从慢性支气管炎的骨密度改变论久咳伤肾.华西医学, 1992, 7：46-47.
9.	辛洪涛,侯林江,孔祥辉. 慢性阻塞性肺病钙磷调节激素与骨矿含量的研究.实用中西医结合杂志，1998，11：577-579.
10.	Kumeda Y，Lnaba M，Nishizawa Y.Secondary osteporosis and its treatment--diabetes mellitus.Nippon Rinsho，1998，56：1579-1586.
11.	Sin DD，Man JP，Man SF.The risk of osteoporosis in Caucasian men and women with obstructive airways disease.Am J Med，2003，114：10-14.
12.	Wouters EF，Creutzberg EC，Schols AM.Systemic effects in COPD.Chest，2002，121：127S-130S.
13.	Varkey AB.Chronic obstructive pulmonary disease in women：exploring gender differences.Curr Opin in Pulm Med，2004，10：98-103.
14.	Katsura H，Kida K.A comparison of bone mineral density in elderly female patients with COPD and bronchial asthma.Chest，2002，122：1949-1955.
15.	Tschopp O，Boehler A，Speich R，et al.Osteoporosis before lung transplantation：association with low body mass index，but not with underlying disease.Am J Transplant，2002，2：167-172.
16.	Gan WQ，Man SF，Senthilselvan A，et al.Association between chronic obstructive pulmonary disease and systemic inflammation：a systematic review and a meta-analysis.Thorax，2004，59：574-580.
17.	Eid AA，Ionescu AA，Nixon LS，et al.Inflammatory response and body composition in chronic obstructive pulmonary disease.Am J Respir Crit Care Med，2001，164：1414-1418.
18.	李卫，苗懿德.老年男性慢性阻塞性肺疾病患者骨代谢的研究.中国骨质疏松杂志，2005，11：221-224.
19.	凌万军，葛春方.烟酒对骨密度的影响.中华预防医学杂志，1999，33：63.
20.	Shane E，Silverberg SJ，Donovan D，et al.Osteoporosis in lung transplantation candidates with end-stage pulmonary disease.Am J Med，1996，101：262-269.
21.	Seeman E.The effects of tobacoo and alconol use on bone.In：Marcus R，Feldman D，Kelsey J，eds.Osteoporosis.Osteoporosis.San Diego：Academic Press，1996，577-597.
22.	Gan WQ，Man SF，Sin DD.Effects of inhaled corticosteroids on sputum cell counts in stable chronic obstructive pulmonary disease：a systematic review and a meta-analysis.BMC Pulm Med，2005，5：3.
23.	Sin DD，Wu L，Anderson JA，et al.Inhaled corticosteroids and mortality in chronic obstructive pulmonary disease.Thorax，2005，60：992-997.
24.	Lung Health Study Research Group.Effect of inhaled triamcinolone on the decline in pulmonary function in chronic obstructive pulmonary disease.N Engl J Med，2000，343：1902-1909.
25.	Scanlon PD，Connett JE，Wise RA，et al.Loss of bone density with inhaled triamcinolone in Lung Health Study II.Am J Respir Crit Care Med，2004；170：1302-1309.
26.	Canalis E.Clinical review 83：Mechanisms of glucocorticoid action in bone：implications to glucocorticoid-induced osteoporosis.J Clin Endocrinol Metab，1996，81：3441-3447.
27.	Adachi JD.Corticosteroid-induced osteoporosis.Am J Med Sci，1997，313：41-49.
28.	Lane NE，Lukert B.The science and therapy of glucocorticoid-induced bone loss.Endocrinol Metab Clin North Am，1998，27：465-483.

1. Spurzem JR，Rennard SI.Pathogenesis of COPD.Semin Respir Crit Care Med，2005，26：142-153.
2. Jørgensen NR，Schwarz P，Holme I，et al.The prevalence of osteoporosis in patients with chronic obstructive pulmonary disease：a cross sectional study.Respir Med，2007，101：177-185.
3. 中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南.中华内科杂志，2002，41：640-646.
4. Bolton CE，Ionescu AA，Shiels KM，et al.Associated loss of fat-free mass and bone mineral density in chronic obstructive pulmonary disease.Am J Respir Crit Care Med，2004，170：1286-1293.
5. Balasubramanian VP，Varkey B.Chronic obstructive pulmonary disease：effects beyond the lungs.Curr Opin Pulm Med，2006，12：106-112.
6. Papaioannou A，Parkinson W，Ferko N，et al.Prevalence of vertebral fractures among patients with chronic obstructive pulmonary disease in Canada.Osteoporos Int，2003，14：913-917.
7. 李斯南.43例慢性阻塞性肺病患者骨密度和骨代谢的改变.医药论坛杂志，2003，24：27-28.
8. 郭素华,杨定焯,许志奇,等.从慢性支气管炎的骨密度改变论久咳伤肾.华西医学, 1992, 7：46-47.
9. 辛洪涛,侯林江,孔祥辉. 慢性阻塞性肺病钙磷调节激素与骨矿含量的研究.实用中西医结合杂志，1998，11：577-579.
10. Kumeda Y，Lnaba M，Nishizawa Y.Secondary osteporosis and its treatment--diabetes mellitus.Nippon Rinsho，1998，56：1579-1586.
11. Sin DD，Man JP，Man SF.The risk of osteoporosis in Caucasian men and women with obstructive airways disease.Am J Med，2003，114：10-14.
12. Wouters EF，Creutzberg EC，Schols AM.Systemic effects in COPD.Chest，2002，121：127S-130S.
13. Varkey AB.Chronic obstructive pulmonary disease in women：exploring gender differences.Curr Opin in Pulm Med，2004，10：98-103.
14. Katsura H，Kida K.A comparison of bone mineral density in elderly female patients with COPD and bronchial asthma.Chest，2002，122：1949-1955.
15. Tschopp O，Boehler A，Speich R，et al.Osteoporosis before lung transplantation：association with low body mass index，but not with underlying disease.Am J Transplant，2002，2：167-172.
16. Gan WQ，Man SF，Senthilselvan A，et al.Association between chronic obstructive pulmonary disease and systemic inflammation：a systematic review and a meta-analysis.Thorax，2004，59：574-580.
17. Eid AA，Ionescu AA，Nixon LS，et al.Inflammatory response and body composition in chronic obstructive pulmonary disease.Am J Respir Crit Care Med，2001，164：1414-1418.
18. 李卫，苗懿德.老年男性慢性阻塞性肺疾病患者骨代谢的研究.中国骨质疏松杂志，2005，11：221-224.
19. 凌万军，葛春方.烟酒对骨密度的影响.中华预防医学杂志，1999，33：63.
20. Shane E，Silverberg SJ，Donovan D，et al.Osteoporosis in lung transplantation candidates with end-stage pulmonary disease.Am J Med，1996，101：262-269.
21. Seeman E.The effects of tobacoo and alconol use on bone.In：Marcus R，Feldman D，Kelsey J，eds.Osteoporosis.Osteoporosis.San Diego：Academic Press，1996，577-597.
22. Gan WQ，Man SF，Sin DD.Effects of inhaled corticosteroids on sputum cell counts in stable chronic obstructive pulmonary disease：a systematic review and a meta-analysis.BMC Pulm Med，2005，5：3.
23. Sin DD，Wu L，Anderson JA，et al.Inhaled corticosteroids and mortality in chronic obstructive pulmonary disease.Thorax，2005，60：992-997.
24. Lung Health Study Research Group.Effect of inhaled triamcinolone on the decline in pulmonary function in chronic obstructive pulmonary disease.N Engl J Med，2000，343：1902-1909.
25. Scanlon PD，Connett JE，Wise RA，et al.Loss of bone density with inhaled triamcinolone in Lung Health Study II.Am J Respir Crit Care Med，2004；170：1302-1309.
26. Canalis E.Clinical review 83：Mechanisms of glucocorticoid action in bone：implications to glucocorticoid-induced osteoporosis.J Clin Endocrinol Metab，1996，81：3441-3447.
27. Adachi JD.Corticosteroid-induced osteoporosis.Am J Med Sci，1997，313：41-49.
28. Lane NE，Lukert B.The science and therapy of glucocorticoid-induced bone loss.Endocrinol Metab Clin North Am，1998，27：465-483.

Chinese Journal of Respiratory and Critical Care Medicine

Relationship between osteoporosis and chronic obstructive pulmonary disease in elderly male patients

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