Bone mineral density and fractures in older men with chronic obstructive pulmonary disease or asthma
In 5,541 community dwelling men, chronic obstructive pulmonary disease, or asthma was associated with lower bone mineral density (BMD) at the spine and total hip and an increased risk of vertebral and nonvertebral fractures independent of age, body mass index, and smoking. Men prescribed with corticosteroids had the lowest BMD.
It is unclear whether chronic obstructive pulmonary disease (COPD) is independently associated with BMD and fractures.
In 5,541 men from the Osteoporotic Fractures in Men Study, history of COPD or asthma, current treatment with corticosteroids, BMD, bone loss after 4.5 years and fractures were ascertained.
Seven hundred fourteen (13%) men reported COPD or asthma, of which 103 were prescribed an oral steroid and 177 an inhaled steroid. Independent of confounders, men prescribed corticosteroids for COPD or asthma had the lowest BMD and a 2-fold increased risk of vertebral osteoporosis compared to men with no history of COPD or asthma (OR 2.13, 95% CI (confidence interval) 1.15–3.93 oral steroids; OR 2.05, 95% CI 1.27–3.31 inhaled steroids). During follow-up, BMD increased at the spine, but there was no difference in bone loss at the hip. However, men with COPD or asthma had a 2.6- and 1.4-fold increased risk of vertebral and nonvertebral fractures, respectively.
Chronic obstructive pulmonary disease or asthma was associated with lower BMD at the spine and hip and increased risk of vertebral and nonvertebral fractures independent of age, clinic site, BMI, and smoking. A history of COPD or asthma may be a useful clinical risk factor to identify patients with osteoporosis.
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- Bone mineral density and fractures in older men with chronic obstructive pulmonary disease or asthma
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Volume 21, Issue 8 , pp 1341-1349
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- Author Affiliations
- 1. Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York, USA
- 6. Columbia University, College of Physicians and Surgeons, 5141 Broadway, New York, New York, 10035, USA
- 2. Research Institute, California Pacific Medical Center, San Francisco, California, USA
- 3. Geriatric Research Education and Clinical Center and Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
- 4. Department of Medicine, School of Medicine, University of California San Diego, La Jolla, California, USA
- 5. Department of Family and Preventive Medicine, School of Medicine, University of California San Diego, La Jolla, California, USA