Watanabe Reiko, Inoue Daisuke
Third Department of Medicine, Teikyo University Chiba Medical Center, Ichihara, Japan.
Clin Calcium. 2018;28(12):1647-1652.
Chronic obstructive pulmonary disease(COPD), an inflammatory disease of the lung mainly caused by cigarette smoking, is a systemic disease associated with various extra-pulmonary comorbidities such as osteoporosis, ischemic heart disease and sarcopenia. Osteoporosis is one of such complications, and the prevalence of vertebral fractures in COPD is high even in early COPD stages. Loss of bone mineral density as well as deterioration of bone quality is common in COPD patients. However, the pathophysiology of bone fragility in COPD-associated osteoporosis is still incompletely understood. COPD patients are exposed to various disease-specific risk factors such as systemic inflammation, glucocorticoid use and vitamin D insufficiency/deficiency, accumulation of which leads to development of COPD-associated osteoporosis. Vitamin D repletion and timely intervention with anti-osteoporotics would be important to protect COPD patients from fracture.
慢性阻塞性肺疾病（COPD）是一种主要由吸烟引起的肺部炎症性疾病，是一种与多种肺外合并症相关的全身性疾病，如骨质疏松症、缺血性心脏病和肌肉减少症。骨质疏松症就是其中一种并发症，即使在COPD早期阶段，COPD患者椎体骨折的患病率也很高。COPD患者骨矿物质密度降低以及骨质恶化很常见。然而，COPD相关性骨质疏松症中骨脆性的病理生理学仍未完全了解。COPD患者暴露于各种疾病特异性风险因素，如全身炎症、糖皮质激素使用和维生素D不足/缺乏，这些因素的累积导致COPD相关性骨质疏松症的发生。补充维生素D以及及时使用抗骨质疏松药物进行干预对于保护COPD患者免受骨折至关重要。
