Lee Sang Hee, Kwon Hye-Young
Department of Internal Medicine, Wonkwang University Sanbon Hospital, Gunpo, Korea.
Division of Biomedicine & Public Health, Mokwon University, Daejeon, Korea.
J Bone Metab. 2017 Nov;24(4):241-248. doi: 10.11005/jbm.2017.24.4.241. Epub 2017 Nov 30.
In this study, we evaluated the prevalence of osteoporosis, risk factors associated with osteoporosis, and health-related quality of life (HRQOL) in clinically stable chronic obstructive pulmonary disease (COPD) patients.
A total of 1,081 COPD patients were recruited from the Korea National Health and Nutrition Examination Survey (KNHANES) from July 2008 to May 2011. Bone mineral densities at the lumbar spine, femoral neck, and total proximal femur were measured using dual energy X-ray absorptiometry. HRQOL was assessed using the EuroQOL-5 dimensions (EQ-5D) questionnaire. To identify factors associated with osteoporosis and HRQOL in patients with COPD, multivariate regression analyses was performed.
Of the 1,081 COPD patients, 191 (17.7%) were diagnosed with osteoporosis. There were significant differences in age, sex, smoking status, education level, house income, and body mass index (BMI) between the osteoporotic and non-osteoporotic groups. COPD patients with osteoporosis had significantly lower EQ-5D scores than the controls. In multivariate analyses, older age (odds ratio [OR]=1.10, <0.001) was risk factor for osteoporosis. And patients of male sex (OR=0.06, <0.001), high house income (OR=0.75, =0.045), and high BMI (OR=0.74, <0.001) were less likely to have osteoporosis. In addition, osteoporosis was associated with poor HRQOL (β=-0.21, =0.023).
The prevalence of osteoporosis in COPD patients based on the 2008 to 2011 KNHANES data were relatively lower than that in physician-diagnosed COPD patients. In these COPD patients, older age, female sex, low household income, and low BMI increased the risk for osteoporosis.
在本研究中,我们评估了临床稳定的慢性阻塞性肺疾病(COPD)患者中骨质疏松症的患病率、与骨质疏松症相关的危险因素以及健康相关生活质量(HRQOL)。
2008年7月至2011年5月期间,从韩国国家健康与营养检查调查(KNHANES)中招募了1081例COPD患者。使用双能X线吸收法测量腰椎、股骨颈和股骨近端的骨密度。使用欧洲五维健康量表(EQ-5D)问卷评估HRQOL。为了确定COPD患者中与骨质疏松症和HRQOL相关的因素,进行了多因素回归分析。
在1081例COPD患者中,191例(17.7%)被诊断为骨质疏松症。骨质疏松组和非骨质疏松组在年龄、性别、吸烟状况、教育水平、家庭收入和体重指数(BMI)方面存在显著差异。患有骨质疏松症的COPD患者的EQ-5D评分明显低于对照组。在多因素分析中,年龄较大(优势比[OR]=1.10,<0.001)是骨质疏松症的危险因素。男性患者(OR=0.06,<0.001)、高家庭收入(OR=0.75,=0.045)和高BMI(OR=0.74,<0.001)患骨质疏松症的可能性较小。此外,骨质疏松症与较差的HRQOL相关(β=-0.21,=0.023)。
基于2008年至2011年KNHANES数据的COPD患者中骨质疏松症的患病率相对低于医生诊断的COPD患者。在这些COPD患者中,年龄较大、女性、低家庭收入和低BMI增加了患骨质疏松症的风险。