Fountoulis George, Kerenidi Theodora, Kokkinis Constantinos, Georgoulias Panagiotis, Thriskos Paschal, Gourgoulianis Konstantinos, Fezoulidis Ioannis, Vassiou Katerina, Vlychou Marianna
Department of Radiology, University Hospital of Larissa, University of Thessaly, School of Medicine, Biopolis, 41110 Larissa, Greece.
Pulmonology Clinic, University Hospital of Larissa, University of Thessaly, School of Medicine, Biopolis, 41110 Larissa, Greece.
Int J Endocrinol. 2016;2016:6169721. doi: 10.1155/2016/6169721. Epub 2016 Mar 21.
The purpose of this study is to identify the prevalence of osteoporosis in male patients with chronic obstructive pulmonary disease (COPD) by dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) and to compare the diagnostic abilities of the above methods. Thirty-seven male patients with established COPD were examined with DXA and standard QCT in lumbar spine, including L1, L2, and L3 vertebrae. T-scores and bone mineral density values were calculated by DXA and QCT method, respectively. Comparative assessment of the findings was performed and statistical analysis was applied. QCT measurements found more COPD patients with impaired bone mineral density compared to DXA, namely, 13 (35.1%) versus 12 (32.4%) patients with osteopenia and 16 (43.2%) versus 9 (16.2%) patients with osteoporosis (p = 0.04). More vertebrae were found with osteoporosis by QCT compared to DXA (p = 0.03). The prevalence of osteoporosis among male patients with COPD is increased and DXA may underestimate this risk. QCT measurements have an improved discriminating ability to identify low BMD compared to DXA measurements because QCT is able to overcome diagnostic pitfalls including aortic calcifications and degenerative spinal osteophytes.
本研究旨在通过双能X线吸收法（DXA）和定量计算机断层扫描（QCT）确定慢性阻塞性肺疾病（COPD）男性患者骨质疏松症的患病率，并比较上述方法的诊断能力。对37例确诊为COPD的男性患者进行腰椎DXA和标准QCT检查，包括L1、L2和L3椎体。分别通过DXA和QCT方法计算T值和骨密度值。对结果进行比较评估并应用统计分析。与DXA相比，QCT测量发现更多骨密度受损的COPD患者，即骨质减少患者分别为13例（35.1%）和12例（32.4%），骨质疏松症患者分别为16例（43.2%）和9例（16.2%）（p = 0.04）。与DXA相比，QCT发现更多椎体存在骨质疏松（p = 0.03）。COPD男性患者骨质疏松症的患病率增加，DXA可能低估了这种风险。与DXA测量相比，QCT测量在识别低骨密度方面具有更好的鉴别能力，因为QCT能够克服包括主动脉钙化和退行性脊柱骨赘等诊断陷阱。
