The prevalence of osteopenia and osteoporosis in patients with chronic obstructive pulmonary disease and their relation with disease severity

Fatma Yıldırım; Esra Meltem Koç; Tuğba Körlü Akkale; Sakine Nazik Bahçecioğlu; Nurdan Köktürk

doi:10.7197/223.vi.536515

EN TR

The prevalence of osteopenia and osteoporosis in patients with chronic obstructive pulmonary disease and their relation with disease severity

Abstract

Objective: Osteopenia and osteoporosis are within the systemic features of chronic obstructive pulmonary disease (COPD). The present study aimed to investigate the frequency of osteopenia and osteoporosis in COPD patients and to determine the correlation between bone mineral dansity (BMD) and the clinical characteristics of COPD patients.

Method: This retrospective study was conducted in the department of Pulmonary Medicine, at a university hospital in Turkey between January 2014 to August 2016. Data of 92 patients with COPD who underwent dual energy X-ray absorptiometry to evaluate BMD were extracted from the medical records. Osteopenia/osteoporosis was assessed with the T and Z scores.

Results: Mean age of the patients was 66.2±9.2 years and males comprised 89.1% of the study group. The frequency of osteopenia/osteoporosis in the COPD patients was 63.0%. Osteopenia/osteoporosis frequency was same in GOLD C/D and GOLD A/B patients [12/19 (%63.1) and 46/73 (%63.1)]. Exacerbation number in the previous year and the readmission rates were higher and the duration of hospital stay of the patients with osteoporosis was longer (p<0.05). A significant positive correlation was noted between body mass index and BMD (r=0.489, p<0.001), BMD and FEV1/FVC (r=0.226, p=0.040), exacerbation number in the previous year (r=-0.429, p=0.001) and the duration of hospital stay in admission (r=-0.228, p=0.034). As the severity of GOLD stage increased, the prevalence of osteopenia was also increased (p_trend <0.001).

Conclusions: Our data suggest that the prevalence of osteopenia and osteoporosis in COPD patients is high independent of disease stage. Abnormal BMD results are associated with frequent exacerbation, prolongation of hospital stay, and poor course of the disease.

Keywords

Chronic obstructive pulmonary disease,osteopenia,bone mineral density,osteoporosis,forced expiratory volume in 1 second (FEV1)/ forced vital capacity (FVC)

Kronik obstrüktif akciğer hastalığı olan hastalarda osteopeni ve osteoporoz sıklığı ve hastalık şiddeti ile ilişkisi

Öz

Amaç: Osteopeni ve osteoporoz, kronik obstrüktif akciğer hastalığının (KOAH) sistemik özellikleri içindedir. Bu çalışmada KOAH hastalarında osteopeni ve osteoporoz sıklığını araştırmak ve KOAH hastalarının kemik mineral dansitesi (KMD) ile klinik özellikleri arasındaki ilişkiyi belirlemek amaçlanmıştır.

Yöntem: Bu retrospektif çalışma Türkiye'deki bir üniversite hastanesinde Göğüs Hastalıkları bölümünde Ocak 2014 - Ağustos 2016 tarihleri arasında yapıldı. KMD'yi değerlendirmek için çift enerjili X-ışını absorpsiyometrisi yapılan KOAH'lı 92 hastanın verileri tıbbi kayıtlardan elde edildi. Osteopeni/osteoporoz T ve Z skorları ile değerlendirildi.

Bulgular: Hastaların ortalama yaşı 66.2±9.2 idi ve erkekler çalışma grubunun %89.1'ini oluşturuyordu. KOAH hastalarında osteopeni/osteoporoz sıklığı %63.0 idi. Osteopeni/osteoporoz sıklığı GOLD evre C/D ve GOLD evre A/B hastalarda aynıydı [12/19 (%63.1) ve 46/73 (%63.1)]. Osteoporozu olan hastaların bir önceki yıl alevlenme sayıları ve yeniden basvuru oranları daha yüksek; hastanede kalış süreleri daha uzundu (p<0.05). Vücut kitle indeksi ile KMD (r=0.489, p<0.001), KMD ile FEV1/FVC (r=0.226, p=0.040), KMD ile önceki yıl alevlenme sayısı (r=-0.429, p=0.001) ve KMD ile hastanede yatış süresi (r=-0.228, p=0.034) arasında anlamlı bir korelasyon tespit edildi. GOLD evresinin şiddeti arttıkça, osteopeni prevalansı da artmıştı (p_trend <0.001).GOLD evresinin şiddeti arttıkça, osteopeni prevalansı da artmıştır (Ptrend <0.001).

Sonuç: Verilerimiz KOAH hastalarında evreden bağımsız olarak osteopeni ve osteoporoz sıklığının yüksek olduğunu ortaya koymaktadır. Anormal KMD sonuçları sık alevlenme, hastanede kalış süresinde uzama gibi hastalığın kötü seyri ile ilişkilidir.

Anahtar Kelimeler

Kronik obstrüktif akciğer hastalığı; osteopeni; kemik mineral dansitesi,osteoporoz; 1 saniyede zorunlu ekspirasyon hacmi (FEV1) / zorunlu vital kapasite (FVC)

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Details

Primary Language

English

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Fatma Yıldırım ^*
Türkiye

Esra Meltem Koç
Türkiye

Tuğba Körlü Akkale
Türkiye

Sakine Nazik Bahçecioğlu
Türkiye

Nurdan Köktürk

Publication Date

March 28, 2019

Submission Date

March 6, 2019

Acceptance Date

March 12, 2019

Published in Issue

Year 2019 Volume: 41 Number: 1

DOI

https://doi.org/10.7197/223.vi.536515

IZ

https://izlik.org/JA83PE45HP

Cite

RIS / Bibtex

AMA

1.Yıldırım F, Koç EM, Körlü Akkale T, Nazik Bahçecioğlu S, Köktürk N. The prevalence of osteopenia and osteoporosis in patients with chronic obstructive pulmonary disease and their relation with disease severity. CMJ. 2019;41(1):51-58. doi:10.7197/223.vi.536515