Department of Internal Medicine, Endocrine-Metabolic Science and Biochemistry, University of Siena, Policlinico Le Scotte, Viale Bracci 2, 53100 Siena, Italy.
Osteoporos Int. 2009 Jun;20(6):989-98. doi: 10.1007/s00198-008-0770-4. Epub 2008 Oct 18.
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.
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.
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.
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.
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.
本研究旨在评估椎体骨折的患病率，以探讨 COPD 患者椎体骨折风险的决定因素。椎体骨折的风险与疾病的严重程度密切相关。糖皮质激素的使用和定量超声（QUS）低值可能是另外的危险因素。
慢性阻塞性肺疾病（COPD）似乎与骨质疏松症有关。我们的研究旨在评估椎体骨折的患病率，并探讨 COPD 患者椎体骨折风险的主要决定因素。
在 3030 名 50 岁及以上的门诊 COPD 患者（1778 名男性和 1262 名女性）中，我们评估了：COPD 严重程度、侧位胸部 X 线片上的椎体骨折情况和使用定量超声设备评估的骨状况。
在男性中，COPD 严重程度与骨折之间存在很强的关联（p<0.001），而在女性中，COPD 严重程度与骨折之间的关联处于边缘状态（p=0.049）。在男性中，但不是在女性中，糖皮质激素治疗与椎体骨折显著相关。骨质疏松高风险或中风险的患者发生椎体骨折的风险增加（OR 2.71；95%CI 2.04-3.60 和 OR 1.54；95%CI 1.26-1.88，分别）。逻辑回归分析表明，COPD 严重程度和糖皮质激素治疗（吸入和口服）与椎体骨折风险增加相关。
在 COPD 患者中，椎体骨折的风险与疾病的严重程度密切相关。糖皮质激素的使用和跟骨 QUS 降低可能是另外的危险因素。
