Department of Respiratory Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China.
J Int Med Res. 2022 May;50(5):3000605221094644. doi: 10.1177/03000605221094644.
To assess the relationship between chronic obstructive pulmonary disease (COPD) severity and bone mineral density (BMD) in the whole body and different body areas.
This retrospective, cross-sectional study included patients with COPD. Demographic and lung function data, COPD severity scales, BMD, and T scores were collected. Patients were grouped by high (≥-1) and low (<-1) T scores, and stratified by body mass index, airway obstruction, dyspnoea, and exercise capacity (BODE) index. The relationship between whole-body BMD and BODE was evaluated by Kendall's tau-b correlation coefficient. Risk factors associated with COPD severity were identified by univariate analyses. BMD as an independent predictor of severe COPD (BODE ≥5) was verified by multivariate logistic regression. BMD values in different body areas for predicting severe COPD were assessed by receiver operating characteristic curves.
Of 88 patients with COPD, lung-function indicators and COPD severity were significantly different between those with high and low T scores. Whole-body BMD was inversely related to COPD severity scales, including BODE. Multivariate logistic regression revealed that BMD was independently associated with COPD severity. The area under the curve for pelvic BMD in predicting severe COPD was 0.728.
BMD may be a novel marker in predicting COPD severity, and pelvic BMD may have the strongest relative predictive power.
评估慢性阻塞性肺疾病（COPD）严重程度与全身和不同身体部位骨密度（BMD）之间的关系。
这是一项回顾性、横断面研究，纳入了 COPD 患者。收集了人口统计学和肺功能数据、COPD 严重程度评分、BMD 和 T 评分。根据 T 评分的高低（≥-1 和 < -1）对患者进行分组，并根据体重指数、气道阻塞、呼吸困难和运动能力（BODE）指数进行分层。通过 Kendall's tau-b 相关系数评估全身 BMD 与 BODE 之间的关系。通过单因素分析确定与 COPD 严重程度相关的危险因素。通过多因素逻辑回归验证 BMD 作为预测严重 COPD（BODE≥5）的独立预测因子。通过受试者工作特征曲线评估不同身体区域的 BMD 预测严重 COPD 的价值。
在 88 例 COPD 患者中，T 评分较高和较低的患者之间的肺功能指标和 COPD 严重程度存在显著差异。全身 BMD 与 COPD 严重程度评分呈负相关，包括 BODE。多因素逻辑回归显示，BMD 与 COPD 严重程度独立相关。预测严重 COPD 时，骨盆 BMD 的曲线下面积为 0.728。
BMD 可能是预测 COPD 严重程度的一个新标志物，而骨盆 BMD 可能具有最强的相对预测能力。
