COPD 患者骨质疏松症的患病率及相关因素：一项横断面研究。

Osteoporosis prevalence and associated factors in patients with COPD: a cross-sectional study.

机构信息

Department of Pulmonology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.

出版信息

Respir Care. 2011 Jul;56(7):961-8. doi: 10.4187/respcare.01056. Epub 2011 Feb 21.

DOI:10.4187/respcare.01056

PMID:21352667

Abstract

BACKGROUND

Osteoporosis is one of the systemic features of COPD.

OBJECTIVE

To determine the prevalence of osteoporosis in a sample of COPD out-patients, and investigate the correlation between T-score (a comparison of the patient's bone mineral density to that of a healthy 30-year-old of the same sex and ethnicity) and several factors suggested to be associated with osteoporosis.

METHODS

In a cross-sectional study, we conducted dual-energy X-ray absorptiometry bone mineral density scans of the hips and lumbar spine, and collected data on smoking and alcohol habits, menopausal status, comorbidities, inhaled and oral corticosteroid dose and duration of treatment, previous bone fractures, pulmonary function tests, calcium intake (via questionnaire on food frequency), vitamin D intake (via questionnaire on sunlight exposure), and physical activity (via the International Physical Activity Questionnaire).

RESULTS

We evaluated 95 patients. Forty (42%) were osteoporotic, 40 (42%) were osteopenic, and 15 (16%) had normal bone mass. We found significant bivariate correlations between femoral-neck T-score and body mass index (r = 0.551, P < .001), and femoral-neck T-score and International Physical Activity Questionnaire total activity score (r = 0.378, P < .001). There was a significant inverse relationship between femoral-neck T-score and BODE (body mass index, air-flow obstruction, dyspnea, and exercise capacity) index (r = -0.246, P = .02). We also found significant correlations between T-score and FEV(1) (r = 0.251, P = .01), forced vital capacity (r = 0.229, P = .03), percent-of-predicted functional residual capacity (r = -0.415, P < .001), inspiratory capacity (r = 0.252, P = .01), ratio of inspiratory capacity to total lung capacity (r = 0.241, P = .02), and absolute and percent-of-predicted diffusing capacity of the lung for carbon monoxide (r = 0.366, P < .001, and r = 0.338, P = .003, respectively).

CONCLUSIONS

We identified a high prevalence of osteoporosis and osteopenia in out-patients with COPD. Patients with osteoporosis had more severe COPD than patients with normal bone mass.

摘要

背景

骨质疏松症是 COPD 的全身特征之一。

目的

确定 COPD 门诊患者骨质疏松症的患病率，并研究 T 评分（患者的骨矿物质密度与同性别和种族的健康 30 岁人群的比较）与几个被认为与骨质疏松症相关的因素之间的相关性。

方法

在一项横断面研究中，我们对髋关节和腰椎进行了双能 X 射线吸收法骨矿物质密度扫描，并收集了吸烟和饮酒习惯、绝经状态、合并症、吸入和口服皮质类固醇剂量和治疗持续时间、既往骨折、肺功能检查、钙摄入量（通过食物频率问卷）、维生素 D 摄入量（通过阳光暴露问卷）和身体活动（通过国际体力活动问卷）的数据。

结果

我们评估了 95 例患者。其中 40 例（42%）为骨质疏松症，40 例（42%）为骨量减少，15 例（16%）为正常骨量。我们发现股骨颈 T 评分与体重指数（r = 0.551，P <.001）和股骨颈 T 评分与国际体力活动问卷总活动评分（r = 0.378，P <.001）之间存在显著的双变量相关性。股骨颈 T 评分与 BODE（体重指数、气流阻塞、呼吸困难和运动能力）指数之间存在显著的负相关关系（r = -0.246，P =.02）。我们还发现 T 评分与 FEV1（r = 0.251，P =.01）、用力肺活量（r = 0.229，P =.03）、预计功能残气量百分比（r = -0.415，P <.001）、吸气量（r = 0.252，P =.01）、吸气量与总肺活量的比值（r = 0.241，P =.02）以及绝对和预计一氧化碳弥散量的百分比（r = 0.366，P <.001，和 r = 0.338，P =.003）之间存在显著相关性。