Department of Respiratory Medicine, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 GS Eindhoven, The Netherlands.
Respir Med. 2012 Jun;106(6):861-70. doi: 10.1016/j.rmed.2011.12.020. Epub 2012 Feb 26.
Currently, our knowledge on the progression of osteoporosis and its determinants is limited in patients with chronic obstructive pulmonary disease (COPD). Bone mineral density generally remains stable in patients with COPD over a period of 3 years. Nevertheless, the progression of vertebral fractures was not assessed, while an increase of vertebral fractures over time may be reasonable. Aims of the current study were to determine the percentage of newly diagnosed osteoporotic patients after a follow up of 3 years and to identify baseline risk factors for the progression of osteoporosis in COPD. Clinically stable COPD outpatients were included. Lung function parameters, body composition measures, six minute walk distance, DXA-scan and X-spine were assessed at baseline and repeated after 3 years. Prevalence of osteoporosis in COPD patients increased from 47% to 61% in 3 years mostly due to an increase of vertebral fractures. Lower baseline T-score at the trochanter independently increased the risk for the development of osteoporosis. Additionally, baseline vitamin D deficiency increased this risk 7.5-fold. In conclusion, the prevalence of osteoporosis increased over a 3-year period in patients with COPD. Baseline risk factors for the development of osteoporosis are osteopenia at the trochanter and vitamin D deficiency.
目前，我们对慢性阻塞性肺疾病（COPD）患者骨质疏松症及其决定因素的进展了解有限。在 3 年内，COPD 患者的骨密度通常保持稳定。然而，没有评估椎体骨折的进展情况，而随着时间的推移，椎体骨折的增加可能是合理的。本研究的目的是确定随访 3 年后新诊断为骨质疏松症的患者的百分比，并确定 COPD 中骨质疏松症进展的基线危险因素。纳入临床稳定的 COPD 门诊患者。在基线和 3 年后重复评估肺功能参数、身体成分测量、6 分钟步行距离、DXA 扫描和 X 脊柱。3 年内，COPD 患者的骨质疏松症患病率从 47%增加到 61%，主要是由于椎体骨折的增加。基线股骨转子 T 评分较低独立增加了骨质疏松症发展的风险。此外，基线维生素 D 缺乏使这种风险增加了 7.5 倍。总之，COPD 患者在 3 年内骨质疏松症的患病率增加。骨质疏松症发展的基线危险因素是股骨转子的骨质疏松和维生素 D 缺乏。
