Osteoporosis in COPD patients: Risk factors and pulmonary rehabilitation

Abstract

Objectives To present a review on the pathogenesis, risk factor and treatment of chronic obstructive pulmonary disease complicated with osteoporosis and provide new ideas for the diagnosis and treatment. Data source A systematic search is carried out using keywords as chronic obstructive pulmonary disease, osteoporosis, risk factors, and pulmonary rehabilitation. Results Patients with chronic obstructive pulmonary disease have a high prevalence of osteoporosis and a high risk of fracture. The mechanisms of osteoporosis in COPD patients are associated with general risk factors, such as smoking, reduced physical activity, low weight, and disease‐specific risk factors, such as systemic inflammatory, Vitamin D deficiency, use of glucocorticoid, anemia, hypoxemia, and hypercapnia. The treatment of osteoporosis in COPD emphasizes comprehensive intervention, which mainly include basic treatment and anti‐osteoporosis drugs. Noticeably, pulmonary rehabilitation program is an important part of treatment. Conclusions This work summarizes the pathogenesis, risk factor, prevention, and treatment of chronic obstructive pulmonary disease complicated with osteoporosis, and the latest progress of studies on chronic obstructive pulmonary disease and osteoporosis is discussed.

Pharmacological, Nutritional, and Rehabilitative Interventions to Improve the Complex Management of Osteoporosis in Patients with Chronic Obstructive Pulmonary Disease: A Narrative Review

“…To date, it is widely accepted that COPD and osteoporosis are closely linked. As shown in Figure 1 , several risk factors might coexist and crucially affect osteoporosis risk in COPD patients, including long-term therapy, systemic inflammation, smoke, reduction in physical activity levels, malnutrition, and sarcopenia [ 17 ]. However, to date, the multilevel interactions between different risk factors have not been fully understood yet.…”

“…However, there is still a large gap of knowledge about the role of single risk factors in osteoporosis development in patients with COPD. Moreover, most of the studies currently available assessed multiple associations of factors to have a role in osteoporosis development since the difficulties in isolating single factors [ 17 , 22 , 24 , 30 ]. On the other hand, a specific assessment of the most important contributors to osteoporosis development should be mandatory to set up a personalized multitarget intervention aiming at preventing osteoporosis and maintaining bone health.…”

“…In COPD patients, smoke cessation appears to be the main intervention for arresting the progression of the disease, improving both the overall survival and reducing the risk of long-term complications [ 128 ]. On the other hand, smoke cessation plays a pivotal role also in bone health management given the detrimental effects of nicotine in terms of BMD loss [ 17 ]. In this scenario, a recent meta-analysis by Vestergaard et al [ 129 ] highlighted that smoke cessation significantly reduces the risk of fractures in osteoporotic patients [ 129 ].…”

“…Despite the fact that several modifiable risk factors have been identified to have a role in osteoporosis prevention in COPD patients [ 17 ], several barriers still affect the lifestyle approach to osteoporosis in this patient, while a personalized osteoporosis approach is still far from being fully characterized [ 18 , 19 ].…”

Risk factors for ninety-day readmission following cervical surgery: a meta-analysis

“…COPD patients have respiratory dysfunction, reduced lung volume, and abnormal thoracic activity, which complicate cervical surgery. With the aggravation of COPD, the risk of osteoporosis is higher [37]. COPD patients with osteoporosis may develop osteoporotic vertebral compression fractures after minor trauma or even daily coughing, which increases the probability of rehospitalization [38,39].…”