Original Article

Osteoporosis International

, Volume 18, Issue 9, pp 1197-1202

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

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

  • A. VriezeAffiliated withInstitute of Human Movement Sciences, University of GroningenCenter for Rehabilitation, University Medical Center Groningen
  • , M. H. G. de GreefAffiliated withInstitute of Human Movement Sciences, University of Groningen
  • , P. J. WýkstraAffiliated withDepartment of Pulmonary Diseases, University Medical Center Groningen
  • , J. B. WempeAffiliated withCenter for Rehabilitation, University Medical Center GroningenDepartment of Pulmonary Diseases, University Medical Center Groningen Email author 

Abstract

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 (FEV1) 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 FEV1 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 FEV1 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.

Keywords

Chronic obstructive pulmonary disease Fat-free mass Low bone mineral density Lung function