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Vol. 55. Issue 5.
Pages 252-257 (May 2019)
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Vol. 55. Issue 5.
Pages 252-257 (May 2019)
Original article
DOI: 10.1016/j.arbr.2018.10.013
Frequency of Osteoporosis and Vertebral Fractures in Chronic Obstructive Pulmonary Disease (COPD) Patients
Incidencia de osteoporosis y fracturas vertebrales en pacientes con enfermedad pulmonar obstructiva crónica (EPOC)
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Mariana R. Gazzotti, Carolina M. Roco, Cristiane O. Pradella, Oliver A. Nascimento, Elias F. Porto, Mariana Adas, Marise Lazaretti-Castro, José R. Jardim
Corresponding author
jardimpneumo@gmail.com

Corresponding author.
Escola Paulista de Medicina at the Federal University of São Paulo (EPM/Unifesp) , São Paulo (SP), Brazil
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Figures (2)
Tables (4)
Table 1. Demographic characteristics and lung function.
Table 2. Clinical and demographic characteristics for the COPD group relating to normal bone mass, osteopenia and osteoporosis.
Table 3. Clinical and demographic characteristics of the control group relating to normal bone mass, osteopenia and osteoporosis.
Table 4. Regression model explaining the presence of osteoporosis.
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Abstract
Background

Osteoporosis is a systemic skeletal disease characterized by low bone mass and/or microarchitectural deterioration of bone. Osteoporosis is a risk factor for fractures specially in patients with advanced COPD. The aim of this cross-sectional study was to determine the frequency of osteoporosis and vertebral fracture in COPD patients.

Methods

We evaluated 91 COPD patients and compared to 82 healthy subjects (control group) matched for gender and age. We measured the bone mineral density by means of dual energy X-ray absorptiometry (DXA), evaluating the lumbar vertebra (L1–L4), proximal femur and total femur and evaluated vertebral fractures in thoracic and lumbar spine using X-ray. We questioned patients whether they had had any fall that resulted in any fracture in the past five years.

Results

Males comprised 60.4% of COPD group and 57.3% of the control group. Mean age was 66.2±9.2 years for COPD group and 64.2±8.8 for the control group. The frequency of osteoporosis in the COPD group was 29.7% and 18.3% in control group (p=0.007). The frequency of vertebral fractures was 18.6% in the COPD group and 9.0% in control group (p=0.06). The frequency of reported falls at resulting in any fracture was 36.3% in the COPD group and 7.3% in control group (p=0.001).

Conclusions

Our data indicate that COPD patients present a high frequency of osteoporosis and falls seem to be an important factor for vertebral fracture.

Keywords:
COPD
Fracture
Osteoporosis
Resumen
Introducción

La osteoporosis es una enfermedad sistémica esquelética caracterizada por una baja densidad ósea y/o un deterioro de la microarquitectura del hueso. Constituye un factor de riesgo de fracturas, especialmente en pacientes con EPOC avanzada. El objetivo de este estudio transversal fue determinar la incidencia de osteoporosis y de fracturas vertebrales en pacientes con EPOC.

Métodos

Se evaluaron 91 pacientes con EPOC y se compararon con 82 sujetos sanos (grupo control) emparejados por sexo y edad. Se midió la densidad mineral ósea mediante densitometría ósea (DXA) de la vértebra lumbar (L1-L4), el fémur proximal y el fémur total. Las fracturas en vértebras torácicas y lumbares se evaluaron mediante rayos X. Se preguntó a los pacientes por posibles caídas en los últimos cinco años que pudieran haber resultado en fractura.

Resultados

Los hombres representaron el 60,4% del grupo EPOC y el 57,3% del grupo control. La edad media fue 66,2±9,2 años en el grupo EPOC, y 64,2±8,8 años en el grupo control. La incidencia de osteoporosis en el grupo EPOC fue del 29,7%, y del 18,3% en el grupo control (p=0,06). Se registró una incidencia de caídas resultantes en fracturas del 36,3% en el grupo EPOC y del 7,3% en el grupo control (p=0,001).

Conclusión

Nuestros datos sugieren que los pacientes con EPOC presentan una mayor incidencia de osteoporosis. Las caídas parecen ser un factor relevante en la fractura vertebral.

Palabras clave:
EPOC
Fractura
Osteoporosis

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