Karadag Fisun, Cildag Orhan, Yurekli Yakup, Gurgey Ozgur
Department of Chest Diseases, Adnan Menderes University School of Medicine, 09010 Aydin, Turkey.
J Bone Miner Metab. 2003;21(4):242-6. doi: 10.1007/s00774-002-0416-0.
There are many factors that increase the risk of osteoporosis, including smoking, malnutrition, vitamin D deficiency, hypogonadism, limited physical activity due to chronic disease, and corticosteroid therapy in chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate bone mineral density (BMD) in COPD outpatients receiving regular therapy in order to clarify whether they were suitable candidates for bone mass screening. Twenty-eight male, clinically stable COPD patients (mean age, 63 +/- 9 years) and 20 male volunteer subjects with normal pulmonary function, as a control group (mean age, 63 +/- 5 years) were admitted to the study. The BMD of the COPD patients and control subjects was measured by dual X-ray absorptiometry (Hologic QDR-4000). Pulmonary function tests and arterial blood gas analyses of COPD patients revealed moderate-degree airway obstruction with mild hypoxemia and normal pH. Rates of 42% and 67% for lumbar and femoral osteopenia, respectively, and 35%, and 10% for lumbar and femoral osteoporosis, respectively, were detected in the COPD patients; whereas the rates of lumbar and femoral osteopenia were 40% and 50%, respectively, and the rates of lumbar and femoral osteoporosis were 40% and 15%, respectively, in the control subjects. There was no statistically significant difference between the BMD values of the COPD and control groups. Lumbar BMD was 0.871 g/cm(2) in the COPD patients and 0.853 g/cm(2) in the control group (P = 0.682); femoral BMD was 0.790 g/cm(2) in the COPD patients and 0.795 g/cm(2) in the control group (P = 0.909). Bone density was correlated with the degree of airway obstruction and arterial blood pH. In conclusion, the BMD values of COPD patients were not different from those of control subjects of the same age group. We conclude that the risk of osteoporosis is not increased in appropriately treated patients with moderate-degree COPD, and there is no indication for bone mass screening in this group.
有许多因素会增加骨质疏松症的风险，包括吸烟、营养不良、维生素D缺乏、性腺功能减退、因慢性病导致的身体活动受限以及慢性阻塞性肺疾病（COPD）患者接受的皮质类固醇治疗。本研究的目的是调查接受常规治疗的COPD门诊患者的骨密度（BMD），以明确他们是否适合进行骨量筛查。28名临床稳定的男性COPD患者（平均年龄63±9岁）和20名肺功能正常的男性志愿者作为对照组（平均年龄63±5岁）纳入研究。通过双能X线吸收法（Hologic QDR - 4000）测量COPD患者和对照者的BMD。COPD患者的肺功能测试和动脉血气分析显示为中度气道阻塞伴轻度低氧血症且pH值正常。在COPD患者中，腰椎和股骨骨质减少率分别为42%和67%，腰椎和股骨骨质疏松率分别为35%和10%；而对照组中腰椎和股骨骨质减少率分别为40%和50%，腰椎和股骨骨质疏松率分别为40%和15%。COPD组和对照组的BMD值之间无统计学显著差异。COPD患者的腰椎BMD为0.871g/cm²，对照组为0.853g/cm²（P = 0.682）；COPD患者的股骨BMD为0.790g/cm²，对照组为0.795g/cm²（P = 0.909）。骨密度与气道阻塞程度和动脉血pH值相关。总之，COPD患者的BMD值与同年龄组的对照者无异。我们得出结论，中度COPD患者经适当治疗后骨质疏松风险并未增加，该组患者无需进行骨量筛查。
