Assessment of osteoporosis in patients with chronic obstructive pulmonary disease

Background: COPD is a widely distributed disease with high morbimortality, associated with important pathologies, among which is osteoporosis. However, osteoporosis is often undiagnosed in these patients. Objectives: To evaluate the prevalence of osteoporosis among COPD patients and to determine its relation to demographic data and disease severity. Subjects and methods: This study was conducted on 30 male patients with severe to very severe COPD, in addition to 30 age and sex matched lifelong nonsmoker healthy volunteers. Spirometric indices, serum Ca, phosphorous, ALP, albumin, and PTH were measured. BMD was measured by broadband heel ultrasound method. Results: Corrected Ca was significantly decreased, PTH was significantly increased and ALP showed non-significant increase in the COPD group. As regards BMD; BUA, Z-score and T-score were significantly decreased while RRF was significantly increased in the COPD group. In addition 56.6% of COPD patients had low BMD. Both COPD group either with normal BMD or with low BMD were matched as regards all demographic data. VC%, FVC% and FEV1%, BUA, T-score, and Z-score were significantly decreased while PTH and RRF were significantly increased in the COPD group with low BMD. Z-score was negatively correlated with FEV1 and PTH while BUA was positively correlated with ALP and negatively correlated with FEV1/FVC. Conclusion: Low BMD is prevalent among men with COPD (GOLD stage III–IV) than age matched males. The degree of the loss of BMD has been found to be proportionate to the COPD severity. COPD patients with low BMD have threefold increase in fracture risk