Assessment of reduced mineral bone density in COPD

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is responsible for reduced bone mineral density (BMD). Aim: The aim of this study was to explore and assess the association of low BMDwith systemic inflammation in patients with COPD. Patients and methods: A total of 10 healthy normal control individuals and 30 patients with clinically stable COPD (Global Initiative for Chronic Obstructive Lung Disease stages I–III) were included in the study and divided into four groups. All patients underwent chest radiography; computed tomographic scan of the chest; spirometry; dual-energy X-ray absorptiometry for measurement of BMD of the lumbar (L) spines, forearm, and femur; and blood sampling for measurement of C-reactive protein (CRP) and total and ionized serum calcium. Statistical analysis: Descriptive data are expressed as mean±SD. Pearson’s correlation analysis was used for drawing correlations. Results: Osteoporosis in the spine was detected in 20% of both mild and moderate COPD cases and 100% of severe COPD cases, with statistical significant difference between patients with severe COPD and control group (P=0.027). Osteoporosis in the femur bone was shown in 30, 50, and 90% of mild, moderate, and severe COPD cases, respectively, whereas 20% of moderate and 30% of severe COPD cases had osteoporosis in the forearm. T-scores of BMD were different among the four studied groups (P=0.0001). BMD correlated positively with BMI and forced expiratory volume at timed interval 1 s (%) predicted. CRP values differed significantly between the four studied groups (P=0.0001). CRP correlated negatively with forced expiratory volume at timed interval 1 s (%) predicted and BMD. Conclusion: CRP is seen in high levels with low BMD in severe COPD, indicating the association of low BMD with systemic inflammation in COPD.