Respiratory Division, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium.
Center of Metabolic Bone Diseases, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium.
Chest. 2011 Mar;139(3):648-657. doi: 10.1378/chest.10-1427.
COPD and osteoporosis are strongly associated because of common risk factors such as age, smoking, and inactivity. In addition, COPD-related systemic inflammation, vitamin D deficiency, and the use of systemic corticosteroids enhance ongoing bone destruction. Osteoporosis, in turn, may cause fragility fractures, which further impair mobility and increase morbidity and mortality. Vertebral compression fractures and rib cage fractures in patients with COPD may also reduce pulmonary function or enhance exacerbations. Early prevention and treatment of osteoporosis in COPD is, therefore, important and should be based on integrated risk assessment tools such as FRAX, which take bone mineral density, history of fragility fractures, and population-specific clinical factors into account. As long as intervention studies focusing on the bone in COPD are lacking, a more rigorous application of existing treatment guidelines of osteoporosis in general is mandatory.
COPD 和骨质疏松症密切相关，因为它们有一些共同的危险因素，如年龄、吸烟和不活动。此外，COPD 相关的全身炎症、维生素 D 缺乏和全身皮质类固醇的使用会加剧骨破坏。反过来，骨质疏松症可能导致脆性骨折，进一步降低活动能力，增加发病率和死亡率。COPD 患者的椎体压缩性骨折和肋骨骨折也可能降低肺功能或加重加重。因此，COPD 患者的骨质疏松症的早期预防和治疗很重要，应该基于综合风险评估工具，如 FRAX，它考虑了骨密度、脆性骨折史和特定人群的临床因素。由于目前缺乏针对 COPD 患者骨骼的干预研究，因此必须更严格地应用现有的一般骨质疏松症治疗指南。
