Bone Mineral Density Improvement After Lung Volume Reduction Surgery for Severe Emphysema

Mineo, Tommaso Claudio; Ambrogi, Vincenzo; Mineo, Davide; Fabbri, Andrea; Fabbrini, Elisa; Massoud, Renato

doi:10.1378/chest.127.6.1960

Cited by 55 publications

(41 citation statements)

References 28 publications

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“…It would be compelling to study the effect on bone density of interventions aiming at increasing daily physical activity. In fact, it has already been shown that patients with COPD present an improvement in bone mineral density after lung volume reduction surgery, which has been ascribed to an increase in physical activity [25].…”

Section: Discussionmentioning

confidence: 99%

Low bone mineral density in COPD patients related to worse lung function, low weight and decreased fat-free mass

et al. 2007

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Summary Low bone mineral density is frequently seen in COPD patients. Advanced COPD, low BMI and muscle depletion are risk factors for developing low bone mineral density (BMD). Low bone mineral density is seen in 75% of the GOLD stage IV patients. Introduction We set out to investigate the prevalence of low bone mineral density (BMD) in chronic obstructive pulmonary disease (COPD) as well as the predictors of abnormal bone mineral density. Methods A cross-sectional design was used to evaluate 115 subjects with COPD (GOLD stages II-IV). Bone mineral density (BMD) was measured using an ultrasound densitometer. The forced expiratory volume in 1 s (FEV 1 ) was assessed and fat-free mass was measured using bioelectrical impedance analysis. Chi-square tests and logistic regression were used for analysis. Results The prevalence of a T-score < −1.0 SD and > −2.5 SD was 28.6% in GOLD stage II, 40.3% in GOLD stage III and 57.1% in GOLD stage IV. The prevalence of a T-score ≤−2.5 SD was 0% in GOLD stage II, 9.6% in GOLD stage III and 17.9% in GOLD stage IV. In a logistic model FFM, BMI and FEV 1 were significant predictors of abnormal bone mineral density. Patients in GOLD stage IV have a 7.6 times greater risk of abnormal bone mineral density than patients in GOLD stage II. Conclusions Low bone mineral density is frequently present in COPD patients. Low FFM, BMI and FEV 1 are risk factors for developing a low T-score. A low FFM or BMI in GOLD stage IV strongly suggests loss of BMD and warrants further examination.

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Section: Discussionmentioning

confidence: 99%

Low bone mineral density in COPD patients related to worse lung function, low weight and decreased fat-free mass

et al. 2007

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“…All these changes appeared correlated with the surgical reduction of residual volume [12,[25][26][27].…”

Section: Commentmentioning

confidence: 72%

“…Resting energy expenditure and metabolism were evaluated for the first time by using a calorimetric chamber with indirect methods. In addition, nutrional status was more accurately evaluated in comparison with our previous studies [26,27] by using dual-energy X-ray absorptiometry for body composition, both fat and fat-free mass.…”

Section: Commentmentioning

confidence: 99%

Resting Energy Expenditure and Metabolic Changes After Lung Volume Reduction Surgery for Emphysema

Mineo¹,

Pompeo²,

Mineo³

et al. 2006

The Annals of Thoracic Surgery

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Background. Oxygen consumption volume (VO 2 ) and resting energy expenditure are increased in emphysema because of impaired respiratory function and mechanics, with greater oxygen cost of breathing and altered metabolism. We hypothesized that lung volume reduction surgery may improve energy expenditure and metabolism.Methods. In this 1-year prospective study, 30 patients with moderate-to-severe emphysema underwent bilateral lung volume reduction surgery; 28 similar patients, who refused operation, followed a standard respiratory rehabilitation program. Oxygen consumption volume and resting energy expenditure, both corrected for fat-free mass, VO 2 proportion of respiratory muscles (%VO 2 Resp), respiratory quotient, and energy substrate oxidation were determined by using a calorimetric chamber with indirect methods.Results. Only after surgery significant improvements resulted in 1-second forced expiratory volume (؉20.4%, p ‫؍‬ 0.009), residual volume (؊24.8%, p ‫؍‬ 0.001), diffusion-lung carbon-monoxide (؉18.4%, p ‫؍‬ 0.008), body mass index (؉5.5%, p ‫؍‬ 0.01), resting energy expenditure (؊8.2%, p ‫؍‬ 0.006), and %VO 2 Resp (؊44.1%, p ‫؍‬ 0.0008) with increase in respiratory quotient (0.79 versus 0.84,

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“…In spite of oral steroid therapy, bone density improved after the surgery, which was maintained after surgery in about 50% of patients, suggesting association of emphysema and osteoporosis. 28 Low BMI has shown to be predictive of osteoporosis among COPD patients.…”

Section: Discussionmentioning

confidence: 99%

Measurement of bone mineral density in stable COPD patients using ultrasound densitometry: prevention is better than cure

Ali

Salve

2017

Int J Community Med Public Health

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Background: COPD is a multisystem disorder and three or more comorbidities are associated with poor prognosis. Osteoporosis is one of the major comorbidity and is associated with an impact on the primary dysfunction in COPD. Bone Mineral density measures strength of the skeletal system and ultrasound based BMD measurement is a cheap, cost effective intervention which is also free from ionizing radiation. Ultrasound densitometer BMD measurement can be utilized for screening of osteoporosis in COPD patients. Methods: 50 stable COPD (diagnosed as per GOLD guideline) patients attending a post graduate institute in Mumbai were enrolled for the study and bone mineral density was measured using ultrasonography BMD scan of calcaneum. Results: Among 50 enrolled COPD patients, 27 (54%) patients had osteopenia and 14 (28%) were osteoporotic.9 (64.3%) female and 18 (50%) male COPD patients had osteopenia. 4 (28.6%) females and 10 (27.8%) males were osteoporotic. Conclusions: Considering the additional burden of osteoporosis on management of COPD, it is advisable to measure BMD to formulate strategies to prevent fractures in COPD patients.

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Bone Mineral Density Improvement After Lung Volume Reduction Surgery for Severe Emphysema

Cited by 55 publications

References 28 publications

Low bone mineral density in COPD patients related to worse lung function, low weight and decreased fat-free mass

Low bone mineral density in COPD patients related to worse lung function, low weight and decreased fat-free mass

Resting Energy Expenditure and Metabolic Changes After Lung Volume Reduction Surgery for Emphysema

Measurement of bone mineral density in stable COPD patients using ultrasound densitometry: prevention is better than cure

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