Bone mineral density and vertebral fractures and their relationship with pulmonary dysfunction in patients with chronic obstructive pulmonary disease

Costa, Tommaso; Costa, Fabio Marcelo; Jonasson, T. Hoffman; Moreira, Carolina Aguiar; Boguszewski, César Luiz; Borges, João Lindolfo Cunha; Borba, Victória Zeghbi Cochenski

doi:10.1007/s00198-018-4643-1

Cited by 15 publications

(5 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In fact, a study by Vrieze et al suggested a correlation between a low BMD and the severity of chronic obstructive pulmonary disease (COPD) [ 21 ]. Although in the literature there are controversial data regarding the association of osteoporotic fractures with severity in lung disease, some papers have reported that subjects with COPD present an increased fracture risk, independent of prior glucocorticoid therapy [ 22 ]. On the contrary, other studies have reported that disease severity is not significantly associated with fractures [ 23 ], but that vertebral fractures are associated with increasing age and that patients over 63 years of age are at higher risk.…”

Section: Discussionmentioning

confidence: 99%

Timing of Osteoporotic Vertebral Fractures in Lung and Heart Transplantation: A Longitudinal Study

Caffarelli

Pitinca

Alessandri

et al. 2020

JCM

View full text Add to dashboard Cite

Bone loss and bone fractures are common complications after organ transplantation. Many factors contribute to the pathogenesis of transplant osteoporosis, such as bone disease preceding transplantation, immunosuppressive medications, and nutritional and lifestyle factors. This study aimed to assess the incidence of vertebral fractures before and after lung and heart transplantation. This longitudinal study analyzed 213 electronic medical records of patients who underwent lung transplantation (n = 128) and heart transplantation (n = 85) at Siena University Medical Center between January 2000 and December 2018. In lung and heart transplant recipients, the bone mineral density in the femoral sub-regions show a significant decrease at post-transplantation and at follow up visits. In both lung and heart recipients, we found an increase in the fracture incidence in the first period after transplantation (19.5% vs. 50.4% in lung recipients; 9.6% vs. 25.7% in heart recipients). Moreover, in lung recipients, vertebral fractures were predicted primarily by age, BMD at the femur, and any history of fracture. In heart recipients, vertebral fractures were predicted only by history of fracture. Our study supports the recommendations for pre-transplant osteoporosis screening in patients undergoing lung transplants, and in the first period after transplantation in heart transplant recipients.

show abstract

Section: Discussionmentioning

confidence: 99%

Timing of Osteoporotic Vertebral Fractures in Lung and Heart Transplantation: A Longitudinal Study

Caffarelli

Pitinca

Alessandri

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…Our study utilized the NHIRD, while related studies were based on hospital-based datasets. Furthermore, our study had a 14-year follow-up period and a sample size of nearly 1.3 million, which differs from previous studies with smaller sample sizes [ 22 – 27 ]. Additionally, most previous studies used dual-energy X-ray absorptiometry scans and T-scores to detect osteoporosis, while our study relied on clinical diagnosis.…”

Section: Discussionmentioning

confidence: 90%

Epidemiology of Osteoporosis in Patients with Chronic Obstructive Pulmonary Disease in Taiwan

Liao,

Shen,

Chiu

et al. 2024

J Epidemiol Glob Health

View full text Add to dashboard Cite

Background Chronic obstructive pulmonary disease (COPD) is a preventable and treatable chronic condition characterized by progressive, partially reversible airflow obstruction. Osteoporosis represents a significant comorbidity in individuals with COPD. However, the incidence and prevalence of osteoporosis among the COPD population remain unclear in Taiwan. Therefore, our objective is to investigate the incidence and prevalence of osteoporosis in patients with COPD. Methods In this cross-sectional study, we enrolled a COPD population retrieved from the Taiwan National Health Insurance Research Database (NHIRD) spanning the years 2003 to 2016. Osteoporosis patients were identified using diagnosis codes. The study included newly diagnosed COPD patients from 2003 to 2016. The case group comprised patients who developed osteoporosis or osteoporotic fractures after their COPD diagnosis. We calculated the prevalence and incidence of osteoporosis in individuals with COPD and conducted trend tests. Results A total of 1,297,579 COPD patients were identified during the period from 2003 to 2016, with 275,233 of them in the osteoporosis group. The average prevalence of osteoporosis among individuals with COPD was 21.21% from 2003 to 2016 in Taiwan. The number of osteoporosis cases increased from 6,727 in 2003 to 24,184 in 2016. The prevalence of osteoporosis among COPD patients increased from 3.62% in 2003 to 18.72% in 2016. The number of osteoporosis cases among individuals with COPD continued to rise over the years, reaching its highest point in 2016 with 24,184 new cases. The incidence of osteoporosis fluctuated during the study period but generally remained around 3,000 cases per 100,000 person-years. Notably, there was a significant upward trend in incidence from 2003 to 2006, after which the trend stabilized and remained relatively constant. Conclusions Our study highlights an increase in both the prevalence and incidence of osteoporosis in individuals with COPD. Given the significant medical, economic, and social implications associated with osteoporosis, a comprehensive and robust assessment of its healthcare burden can offer valuable insights for healthcare system planning and policymaking.

show abstract

“…First, this study was performed in smokers with and without COPD. Therefore, the results cannot be generalized to other populations, as smoking and COPD are independent risk factors for VFs and have different pathophysiology as compared to postmenopausal women and elderly [ 37 , 38 ]. However, the peaks of prevalent VFs were similar as found in population studies in postmenopausal women and in men.…”

Section: Discussionmentioning

confidence: 99%

Associations between bone attenuation and prevalent vertebral fractures on chest CT scans differ with vertebral fracture locations

et al. 2021

View full text Add to dashboard Cite

Summary Vertebral fracture (VF) locations are bimodally distributed in the spine. The association between VF and bone attenuation (BA) measured on chest CT scans varied according to the location of VFs, indicating that other factors than only BA play a role in the bimodal distribution of VFs. Introduction Vertebral fractures (VFs) are associated with low bone mineral density but are not equally distributed throughout the spine and occur most commonly at T7–T8 and T11–T12 (“cVFs”) and less commonly at T4–T6 and T9–T10 (“lcVF”). We aimed to determine whether associations between bone attenuation (BA) and VFs vary between subjects with cVFs only, with lcVFs only and with both cVFs and lcVFs. Methods Chest CT images of T4–T12 in 1237 smokers with and without COPD were analysed for prevalent VFs according to the method described by Genant (11,133 vertebrae). BA (expressed in Hounsfield units) was measured in all non-fractured vertebrae (available for 10,489 vertebrae). Linear regression was used to compare mean BA, and logistic regression was used to estimate the association of BA with prevalent VFs (adjusted for age and sex). Results On vertebral level, the proportion of cVFs was significantly higher than of lcVF (5.6% vs 2.0%). Compared to subjects without VFs, BA was 15% lower in subjects with cVFs ( p < 0.0001), 25% lower in subjects with lcVFs ( p < 0.0001) and lowest in subjects with cVFs and lcVFs (− 32%, p < 0.0001). The highest ORs for presence of VFs per − 1SD BA per vertebra were found in subjects with both cVFs and lcVFs (3.8 to 4.6). Conclusions The association between VFs and BA differed according to VF location. ORs increased from subjects with cVFs to subjects with lcVFs and were highest in subjects with cVFs and lcVFs, indicating that other factors than only BA play a role in the bimodal VF distribution. Trial registration Clinicaltrials.gov identifier: NCT00292552

show abstract

Bone mineral density and vertebral fractures and their relationship with pulmonary dysfunction in patients with chronic obstructive pulmonary disease

Abstract: COPD patients have a higher prevalence of MVF and low BMD, and the latter was associated with the severity and poor prognosis of the disease.

Cited by 15 publications

References 29 publications

Timing of Osteoporotic Vertebral Fractures in Lung and Heart Transplantation: A Longitudinal Study

Timing of Osteoporotic Vertebral Fractures in Lung and Heart Transplantation: A Longitudinal Study

Epidemiology of Osteoporosis in Patients with Chronic Obstructive Pulmonary Disease in Taiwan

Associations between bone attenuation and prevalent vertebral fractures on chest CT scans differ with vertebral fracture locations

Contact Info

Product

Resources

About