The prevalence of osteopenia and osteoporosis in patients with chronic obstructive pulmonary disease and their relation with disease severity
Öz
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 (ptrend
<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.
Anahtar Kelimeler
Chronic obstructive pulmonary disease osteopenia bone mineral density osteoporosis forced expiratory volume in 1 second (FEV1)/ forced vital capacity (FVC)
Kaynakça
- 1. Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2014. Available from: http://goldcopd.org.
- 2. Dursunoğlu N, Köktürk N, Baha A, Bilge AK, Börekçi Ş, Çiftçi F et al. Turkish Thoracic Society COPD Comorbidity Group. Comorbities and their impact on chronic obstructive pulmonary disease. Tuberk Toraks 2016;64:292-301.
- 3. Bolton CE, Ionescu AA, Shiels KM, Pettit RJ, Edwards PH, Stone MD et al. Associated loss of fat-free mass and bone mineral density in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2004;170:1286–93.
- 4. Bhattacharyya P, Paul R, Ghosh M, Dey R, Dey R, Barooah N et al. Prevalence of osteoporosis and osteopenia in advanced chronic obstructive pulmonary disease patients. Lung India 2011;28:184–86.
- 5. Watanabe R, Inoue D. Secondary osteoporosis. Chronic obstructive pulmonary disease:COPD. Clin Calcium 2018;28(12):1647-1652.
- 6. Graat-Verboom L, Wouters EF, Smeenk FW, van den Borne BE, Lunde R, Spruit MA. Current status of research on osteoporosis in COPD: a systematic review. Eur Respir J 2009;34:209–18.
- 7. Miller MR, Crapo R, Hankinson J, Brusasco V, Burgos F, Casaburi R, et al. General considerations for lung function. In: Series ‘‘ATS/ERS Task Force: Standardisation of lung function testing”. Eur Respir J 2005;26:153-61.
- 8. Kanis JA. WHO Study Group Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. Osteoporos Int 1994;4(6):368–81.
- 9. International Society for Clinical Densitometry (ISCD) Official Positions– Adult. Available from: http://www.iscd.org/official-positions/2013-iscd-official-positions-adult; 2013.
- 10. Jorgensen NR, Schwarz P, Holme I, Henriksen BM, Petersen LJ, Backer V. The prevalence of osteoporosis in patients with chronic obstructive pulmonary disease: a cross sectional study. Respir Med 2007;101:177–85.
- 11. Silva DR, Coelho AC, Dumke A, Valentini JD, de Nunes JN, Stefani CL et al. Osteoporosis prevalence and associated factors in patients with COPD: a cross-sectional study. Respir Care2011;56:961-8.
- 12. Soriano JB, Visick GT, Muellerova H, Payvandi N, Hansell AL. Patterns of comorbidities in newly diagnosed COPD and asthma in primary care. Chest 2005;128:2099–107.
- 13. Ferguson GT, Calverley PMA, Anderson JA, Jenkins CR, Jones PW, Willits LR et al. Prevalence and progression of osteoporosis in patients with COPD: results from the TOwards a Revolution in COPD Health study. Chest 2009;136(6):1456-1465.
- 14. Graat-Verboom L, van den Borne BE, Smeenk FW, Spruit MA, Wouters EF. Osteoporosis in COPD outpatients based on bone mineral density and vertebral fractures. J Bone Miner Res 2011;26(3):561-8.
- 15. Vrieze A, de Greef MH, Wijkstra PJ, Wempe JB. Low bone mineral density in COPD patients related to worse lung function, low weight and decreased fat-free mass. Osteoporos Int 2007;18(9):1197-202.
- 16.İntepe YS, Yıldırım E, Metin B, Karaçavuş S, Balbaloğlu Ö, Korkmaz M. The Evaluation of Bone Mineral Density in Patients With Chronic Obstructive Pulmonary Disease. Bozok Tıp Derg 2016;1(1):20-6.
- 17. Karapolat H, Eyigör S, Gürgün A, Kirazlı Y, Başoğlu KÖ, Durmaz B. The Evaluation of Osteoporosis in Male Patients with COPD. Osteoporoz DünyasIndan 2007;13:70-4.
- 18. Graumam RQ, Pinheiro MM, Nery LE, Castro CHM. Increased rate of osteoporosis, low lean mass, and fragility fractures in COPD patients: association with disease severity. Osteoporos Int 2018;29(6):1457-1468.
- 19. Lee SH, Kwon HY. Prevalence of Osteoporosis in Korean Patients with Chronic Obstructive Pulmonary Diseaseand Their Health-related Quality of Life According to the Korea National Health and Nutrition Examination Survey 2008-2011. J Bone Metab 2017;24(4):241-248.
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 (ptrend <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)
Kaynakça
- 1. Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2014. Available from: http://goldcopd.org.
- 2. Dursunoğlu N, Köktürk N, Baha A, Bilge AK, Börekçi Ş, Çiftçi F et al. Turkish Thoracic Society COPD Comorbidity Group. Comorbities and their impact on chronic obstructive pulmonary disease. Tuberk Toraks 2016;64:292-301.
- 3. Bolton CE, Ionescu AA, Shiels KM, Pettit RJ, Edwards PH, Stone MD et al. Associated loss of fat-free mass and bone mineral density in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2004;170:1286–93.
- 4. Bhattacharyya P, Paul R, Ghosh M, Dey R, Dey R, Barooah N et al. Prevalence of osteoporosis and osteopenia in advanced chronic obstructive pulmonary disease patients. Lung India 2011;28:184–86.
- 5. Watanabe R, Inoue D. Secondary osteoporosis. Chronic obstructive pulmonary disease:COPD. Clin Calcium 2018;28(12):1647-1652.
- 6. Graat-Verboom L, Wouters EF, Smeenk FW, van den Borne BE, Lunde R, Spruit MA. Current status of research on osteoporosis in COPD: a systematic review. Eur Respir J 2009;34:209–18.
- 7. Miller MR, Crapo R, Hankinson J, Brusasco V, Burgos F, Casaburi R, et al. General considerations for lung function. In: Series ‘‘ATS/ERS Task Force: Standardisation of lung function testing”. Eur Respir J 2005;26:153-61.
- 8. Kanis JA. WHO Study Group Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. Osteoporos Int 1994;4(6):368–81.
- 9. International Society for Clinical Densitometry (ISCD) Official Positions– Adult. Available from: http://www.iscd.org/official-positions/2013-iscd-official-positions-adult; 2013.
- 10. Jorgensen NR, Schwarz P, Holme I, Henriksen BM, Petersen LJ, Backer V. The prevalence of osteoporosis in patients with chronic obstructive pulmonary disease: a cross sectional study. Respir Med 2007;101:177–85.
- 11. Silva DR, Coelho AC, Dumke A, Valentini JD, de Nunes JN, Stefani CL et al. Osteoporosis prevalence and associated factors in patients with COPD: a cross-sectional study. Respir Care2011;56:961-8.
- 12. Soriano JB, Visick GT, Muellerova H, Payvandi N, Hansell AL. Patterns of comorbidities in newly diagnosed COPD and asthma in primary care. Chest 2005;128:2099–107.
- 13. Ferguson GT, Calverley PMA, Anderson JA, Jenkins CR, Jones PW, Willits LR et al. Prevalence and progression of osteoporosis in patients with COPD: results from the TOwards a Revolution in COPD Health study. Chest 2009;136(6):1456-1465.
- 14. Graat-Verboom L, van den Borne BE, Smeenk FW, Spruit MA, Wouters EF. Osteoporosis in COPD outpatients based on bone mineral density and vertebral fractures. J Bone Miner Res 2011;26(3):561-8.
- 15. Vrieze A, de Greef MH, Wijkstra PJ, Wempe JB. Low bone mineral density in COPD patients related to worse lung function, low weight and decreased fat-free mass. Osteoporos Int 2007;18(9):1197-202.
- 16.İntepe YS, Yıldırım E, Metin B, Karaçavuş S, Balbaloğlu Ö, Korkmaz M. The Evaluation of Bone Mineral Density in Patients With Chronic Obstructive Pulmonary Disease. Bozok Tıp Derg 2016;1(1):20-6.
- 17. Karapolat H, Eyigör S, Gürgün A, Kirazlı Y, Başoğlu KÖ, Durmaz B. The Evaluation of Osteoporosis in Male Patients with COPD. Osteoporoz DünyasIndan 2007;13:70-4.
- 18. Graumam RQ, Pinheiro MM, Nery LE, Castro CHM. Increased rate of osteoporosis, low lean mass, and fragility fractures in COPD patients: association with disease severity. Osteoporos Int 2018;29(6):1457-1468.
- 19. Lee SH, Kwon HY. Prevalence of Osteoporosis in Korean Patients with Chronic Obstructive Pulmonary Diseaseand Their Health-related Quality of Life According to the Korea National Health and Nutrition Examination Survey 2008-2011. J Bone Metab 2017;24(4):241-248.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Dahili Tıp Bilimleri Araştırma Yazıları |
| Yazarlar | |
| Yayımlanma Tarihi | 28 Mart 2019 |
| Kabul Tarihi | 12 Mart 2019 |
| Yayımlandığı Sayı | Yıl 2019Cilt: 41 Sayı: 1 |