Osteoporosis International

, Volume 20, Issue 6, pp 989–998

Vertebral fractures in patients with chronic obstructive pulmonary disease: the EOLO Study

  • R. Nuti
  • P. Siviero
  • S. Maggi
  • G. Guglielmi
  • C. Caffarelli
  • G. Crepaldi
  • S. Gonnelli
Original Article

DOI: 10.1007/s00198-008-0770-4

Cite this article as:
Nuti, R., Siviero, P., Maggi, S. et al. Osteoporos Int (2009) 20: 989. doi:10.1007/s00198-008-0770-4

Abstract

Summary

This study aimed to evaluate the prevalence of vertebral fractures to investigate the determinants of vertebral fracture risk in patients with COPD. The risk of vertebral fractures is strictly related to the severity of the disease. The use of glucocorticoids and the presence of low values of quantitative ultrasound (QUS) may represent additional risk factors.

Introduction

Chronic obstructive pulmonary disease (COPD) appears to be associated with osteoporosis. Our study aimed to evaluate the prevalence of vertebral fractures and to investigate the main determinants of vertebral fracture risk in patients with COPD.

Methods

In 3,030 ambulatory COPD patients (1,778 men and 1,262 women) aged 50 years or over, we evaluated: COPD severity, presence of vertebral fractures on lateral chest X-ray and bone status by using a quantitative ultrasound device.

Results

In men there was a strong association between COPD severity and fractures (p < 0.001), conversely in women the association between COPD severity and fractures was at limit (p = 0.049). In men, but not in women, glucocorticoid treatment was significantly associated with vertebral fractures. The patients with high or moderate risk of osteoporosis presented an increased risk of vertebral fracture (OR 2.71; 95% CI 2.04–3.60 and OR 1.54; 95% CI 1.26–1.88, respectively). Logistic regression analysis showed that COPD severity and glucocorticoid treatment, both inhaled and oral, were associated with increased risk of vertebral fractures.

Conclusion

In COPD patients the risk of vertebral fractures is strictly related to the severity of the disease. The use of glucocorticoids and reduced QUS at calcaneous may represent additional risk factors.

Keywords

COPD Glucocorticoids Quantitative ultrasound Vertebral fractures 

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2008

Authors and Affiliations

  • R. Nuti
    • 1
  • P. Siviero
    • 2
  • S. Maggi
    • 2
  • G. Guglielmi
    • 3
  • C. Caffarelli
    • 1
  • G. Crepaldi
    • 2
  • S. Gonnelli
    • 1
  1. 1.Department of Internal Medicine, Endocrine-Metabolic Science and BiochemistryUniversity of SienaSienaItaly
  2. 2.CNR Aging BranchUniversity of PaduaPaduaItaly
  3. 3.Department of Radiology, Scientific Institute HospitalCasa Sollievo della SofferenzaSan Giovanni RotondoItaly

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