COPD 和骨质疏松症：吸入皮质类固醇治疗患者的相关因素。
COPD and Osteoporosis: Associated Factors in Patients Treated with Inhaled Corticosteroids.
机构信息
Department of Physical Medicine and Rehabilitation, Bursa Uludag University, Faculty of Medicine, Bursa, Turkey.
Department of Biostatistics, Bursa Uludag University, Faculty of Medicine, Bursa, Turkey.
出版信息
Int J Chron Obstruct Pulmon Dis. 2020 Oct 9;15:2441-2448. doi: 10.2147/COPD.S274728. eCollection 2020.
PURPOSE
Osteoporosis is a systemic skeletal disease with a consequent increase in fractures rates. Osteoporosis may be primary which is related with normal aging, or secondary which occurs in the presence of an underlying disease or medication. Osteoporosis is one of the significant comorbidities in chronic obstructive pulmonary disease (COPD). In this study, we aimed to investigate the presence of osteoporosis and the influencing factors in COPD patients.
PATIENTS AND METHODS
This is a two-group comparison study that was conducted among 30 COPD patients on inhaled corticosteroid (ICS) and 33 controls. It was conducted in the outpatient clinics at the Departments of Physical Medicine and Rehabilitation and Pulmonary Diseases in Bursa Uludag University Hospital, a tertiary reference center, in the northwest region of Turkey. For both groups, demographic variables, osteoporosis risk questioning, body mass index (BMI), bone mineral density (BMD), biochemical blood tests, vertebral fractures on lumbar and thoracic x-rays were recorded. COPD patients were also evaluated for lung functions via spirometry.
RESULTS
Thirty patients with COPD (Group 1) and 33 controls (Group 2) were included in the study. Comparing the demographic and biochemical data, no difference was found between the groups except smoking (pack/year) (p<0.001) and erythrocyte sedimentation rate (p<0.001), which were significantly high in COPD group. BMD in the COPD group was significantly lower in both hip and lumbar regions compared with the controls. There were significant correlations between L2 BMD values and pulmonary function tests. BMI was significantly low in osteoporotic COPD patients when compared with the non-osteoporotic COPD patients (p=0.002).
CONCLUSION
In patients with COPD using inhaled corticosteroids, BMD was significantly low compared with the controls. Osteoporotic COPD patients had significantly lower BMI than non-osteoporotic. These findings suggest that pulmonary dysfunction and low BMI are associated with osteoporosis in COPD patients.
目的
骨质疏松症是一种全身性骨骼疾病，会导致骨折发生率增加。骨质疏松症可能是原发性的，与正常衰老有关，也可能是继发性的，发生在存在潜在疾病或药物的情况下。骨质疏松症是慢性阻塞性肺疾病（COPD）的重要合并症之一。在这项研究中，我们旨在研究 COPD 患者中骨质疏松症的存在及其影响因素。
患者和方法
这是一项两组比较研究，在吸入皮质类固醇（ICS）的 30 名 COPD 患者和 33 名对照组中进行。该研究在土耳其西北部布尔萨乌鲁达大学医院物理医学和康复科以及肺病科的门诊进行。对两组患者进行了人口统计学变量、骨质疏松症风险询问、体重指数（BMI）、骨密度（BMD）、生化血液检查、腰椎和胸椎 X 光片上的椎体骨折记录。还通过肺活量测定法对 COPD 患者的肺功能进行了评估。
结果
共纳入 30 名 COPD 患者（第 1 组）和 33 名对照组（第 2 组）。比较两组的人口统计学和生化数据，除吸烟（包/年）（p<0.001）和红细胞沉降率（p<0.001）外，两组之间无差异，而 COPD 组明显较高。与对照组相比，COPD 组的髋部和腰椎 BMD 明显较低。L2 BMD 值与肺功能测试之间存在显著相关性。与非骨质疏松性 COPD 患者相比，骨质疏松性 COPD 患者的 BMI 明显较低（p=0.002）。
结论
在使用吸入皮质类固醇的 COPD 患者中，BMD 明显低于对照组。骨质疏松性 COPD 患者的 BMI 明显低于非骨质疏松性 COPD 患者。这些发现表明，肺功能障碍和低 BMI 与 COPD 患者的骨质疏松症有关。
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