OBJECTIVES:
To study the burden of osteoporosis, osteopenia and metabolic abnormality related to bone health in male patients with chronic obstructive airway disease in the age group between 40 to 70 years who are being followed up in Christian Medical College, Vellore.
METHODS:
Clinical methods:
This was a cross sectional study done over a period of two years at Christian Medical College, Vellore. A detailed history and physical examination was done for all male patients with chronic obstructive pulmonary disease in the age group between 40 to 70 years, who were not on bone medications. Blood samples were collected for calcium, phosphorous, albumin, alkaline phosphatase, creatinine, parathormone, 25-hydroxy vitamin D and testosterone. Lung
functions test and six minute walk test were performed. Bone mineral density was assessed using DXA scan (dual energy x-ray absorptiometry).
Statistical methods:
Continuous variables were described using mean and standard deviation, if normally distributed. Interquartile range was used for skewed distribution. All categorical variables
were summarized by using frequencies and percentages. Logistic regression model was constructed to assess the relationship between parameters showing positive correlation with osteoporosis in COPD (Chronic Obstructive Pulmonary Disease).
RESULTS:
A total of 67 patients were enrolled. The prevalence of osteoporosis among the male COPD patients was 61% (41/67) and an additional 33% (22/67) had osteopenia. The prevalence of metabolic bone abnormalities in patients with COPD were: vitamin D deficiency in 69% (46/67), hypocalcaemia in 4%( 3/67), raised alkaline phosphatase in 8% (6/67) and elevated parathormone in 31% (21/67). The factors which showed a trend towards adverse bone health were: advanced age and low body mass index. Although these variables showed a positive trend towards osteoporosis in COPD patients, they did not achieve statistical significance.
CONCLUSION:
In this study the prevalence of osteoporosis and osteopenia among male COPD patients were 61% and 33% respectively, which is noted to be almost twice the prevalence as that of the general population
