Prevalence, risk factors, and health-related quality of life of osteoporosis in patients with COPD at a community hospital in Taiwan

Abstract

BackgroundData regarding osteoporosis in COPD patients in Taiwan remain limited. The primary end point of this study was to evaluate the prevalence and risk factors of osteoporosis in COPD patients in Taiwan. The secondary end point was to examine the association between osteoporosis and health-related quality of life (HRQL) in COPD patients.Materials and methodsThis prospective cross-sectional study enrolled 125 COPD patients (mean age 73.6 years, forced expiratory volume in 1 second [FEV1] 1.19±0.43 L) who had bone mineral-density measurements performed consecutively. Demographic data, lung function, and HRQL including modified Medical Research Council dyspnea scale, St George’s Respiratory Questionnaire, oxygen-cost diagram, Center for Epidemiologic Studies – depression scale, and COPD Assessment Test scores were recorded.ResultsA total of 50 (40%) participants were diagnosed as having osteoporosis. In a multivariate logistic regression model including age, smoking amount (pack-year), body mass index (BMI), and FEV1, only BMI (odds ratio 0.824, 95% confidence interval 0.73–0.93; P=0.002) and FEV1 (odds ratio 0.360, 95% confidence interval 0.13–0.98; P=0.046) were negatively associated with an increased risk of osteoporosis in COPD patients. In addition, COPD patients with osteoporosis had significantly higher modified Medical Research Council dyspnea scale scores (1.7±0.8 vs 1.4±0.8, P=0.046), St George’s Respiratory Questionnaire scores (36.6 vs 28.0, P=0.01), and COPD Assessment Test scores (14.7±8 vs 11.5±7, P=0.019), and lower oxygen-cost diagram score (4.8±1.8 vs 5.4±1.6, P=0.045) than patients without osteoporosis.ConclusionThe prevalence of osteoporosis in COPD patients was high at a community hospital in Taiwan. BMI and FEV1 were the independent risk factors for osteoporosis in COPD. In addition, COPD patients with osteoporosis had worse HRQL than those without osteoporosis.

A study of chronic obstructive pulmonary disease-specific causes of osteoporosis with emphasis on the emphysema phenotype

“…[6] These are the stage of COPD as measured by FEV1, hypoxia, dyspnea score, and emphysema. [48913142628] Similar to our findings studies are nearly unanimous on the presence of an association between FEV1 and the severity of osteoporosis. [272628] Although the stage of COPD was shown to be an independent risk factor for osteoporosis, it is likely that the association is further enhanced by other factors prevalent in advanced COPD such as cachexia, skeletal muscle weakness, and reduced mobility.…”

Peer Review #1 of "Risk factors for osteoporosis in male patients with chronic obstructive pulmonary disease in Taiwan (v0.1)"

“…Manuscript to be reviewed osteoforosis in our study was lower than the 40% reforted in a recent study also conducted in Chiayi, Taiwan (Lin et al, 2015). This may be exflained by differences in subject enrollment and osteoforosis definition.…”

“…Furthermore, Sin and Man found that the negative association between CRP, and FEV1 and FVC, in COPD fatients was much stronger in men than in women (Sin & Man, 2003). These findings suggest that fersistent systemic inflammation in COPD links worse lung condition with extra-fulmonary comorbidities such as osteoforosis or general cachexia and exflains why some studies revealed that foor fulmonary function farameters such as FEV1 were associated with osteoforosis develofment (Lin et al, 2015;Watanabe et al, 2015).…”

“…However, cumulative results of these studies are inconclusive, and the definite fathogenic mechanism remains unclear. To our knowledge, data regarding risk factors in Taiwan are limited, with no current research regarding the association between inflammation markers or systemic inflammation and osteoforosis develofment (Chen et al, 2015;Lee et al, 2016;Lin et al, 2015;Liu et al, 2015). Therefore, this study frimarily aimed to investigate risk factors for osteoforosis, farticularly whether increased CRP is a fredictor for osteoforosis develofment in male Taiwanese COPD fatients since it is a common and available test in the hosfital.…”

Peer Review #2 of "Risk factors for osteoporosis in male patients with chronic obstructive pulmonary disease in Taiwan (v0.1)"

“…However, cumulative results of these studies are inconclusive, and the definite fathogenic mechanism remains unclear. To our knowledge, data regarding risk factors in Taiwan are limited, with no current research regarding the association between inflammation markers or systemic inflammation and osteoforosis develofment Lee et al, 2016;Lin et al, 2015;Liu et al, 2015). Therefore, this study frimarily aimed to investigate risk It enrolled male COPD fatients aged ≥45 years from a chest outfatient clinic in a regional teaching hosfital in the west Chiayi County, Taiwan.…”