Anar Ceyda, Yüksel Yavuz Melike, Güldaval Filiz, Varol Yelda, Kalenci Dilek
Department of Chest Diseases, İzmir Dr. Suat Seren Chest Diseases and Surgery Training Research Hospital, Gaziler Cad. No: 331, 35110 İzmir, Turkey.
Department of Biochemistry, İzmir Dr. Suat Seren Chest Diseases and Surgery Training Research Hospital, İzmir, Turkey.
Multidiscip Respir Med. 2018 Jan 6;13:1. doi: 10.1186/s40248-017-0116-1. eCollection 2018.
The aim of this paper was to evaluate the availability of FRAX for assessing osteoporosis risk, and to demonstrate the importance of vitamin D levels in COPD patients.
Fourty-six males who fulfilled the COPD diagnostic criteria defined by GOLD were included. Age, race, BMI, physical activity frequency, smoking and dietary habits, age at COPD diagnosis, disease duration, fractures history, and medications use were determined. Levels of 25(OH)D were detected. BMD was measured by DXA at lumbar spine, femoral neck, and entire femur, and classified according to ISCD. FRAX score was calculated. Control group was composed of 40 non-smoker individuals without previous history of pulmonary diseases.
25(OH)D levels were significantly different between patients and controls. In the COPD group, a statistically significant difference in vitamin D levels was detected among the A, B, C, and D grades, while no such significant differences in FRAX scores were detected. 25(OH)D levels were significantly low in COPD patients with disease exacerbations and hospitalizations in the previous one year. No correlation was detected between vitamin D levels and the FRAX score. A positive correlation was observed between vitamin D levels and T-score. FRAX scores were higher and vitamin D levels were lower in osteoporotic COPD patients than in non-osteoporotic COPD patients.
Using FRAX for assessing osteoporosis in COPD can reduce fracture risk and allow adequate treatment. Since vitamin D levels are related to exacerbations and hospitalizations, vitamin D supplementation may be needed in COPD patients, especially in those with high FRAX scores.
本文旨在评估FRAX在评估骨质疏松症风险方面的可用性，并证明维生素D水平在慢性阻塞性肺疾病（COPD）患者中的重要性。
纳入46名符合慢性阻塞性肺疾病全球倡议（GOLD）定义的诊断标准的男性。确定年龄、种族、体重指数（BMI）、身体活动频率、吸烟和饮食习惯、慢性阻塞性肺疾病诊断时的年龄、病程、骨折史和用药情况。检测25羟维生素D[25(OH)D]水平。采用双能X线吸收法（DXA）测量腰椎、股骨颈和全股骨的骨密度，并根据国际骨密度学会（ISCD）进行分类。计算FRAX评分。对照组由40名无肺部疾病既往史的非吸烟个体组成。
患者与对照组之间的25(OH)D水平存在显著差异。在慢性阻塞性肺疾病组中，A、B、C和D级之间的维生素D水平存在统计学显著差异，而FRAX评分未检测到此类显著差异。在过去一年中有疾病加重和住院史的慢性阻塞性肺疾病患者中，25(OH)D水平显著较低。未检测到维生素D水平与FRAX评分之间的相关性。观察到维生素D水平与T值之间存在正相关。骨质疏松性慢性阻塞性肺疾病患者的FRAX评分高于非骨质疏松性慢性阻塞性肺疾病患者，而维生素D水平低于后者。
使用FRAX评估慢性阻塞性肺疾病患者的骨质疏松症可降低骨折风险并实现充分治疗。由于维生素D水平与疾病加重和住院有关，慢性阻塞性肺疾病患者可能需要补充维生素D，尤其是FRAX评分较高的患者。
