Bone mineral density and vertebral fractures and their relationship with pulmonary dysfunction in patients with chronic obstructive pulmonary disease.
To evaluate bone mineral density (BMD) and morphometric vertebral fractures (MVF) in chronic obstructive pulmonary disease (COPD) patients in comparison with two control groups. BMD was lower in the disease group (DG) and was associated with the worst disease severity and prognosis. The prevalence of MVF was high and greater in the DG than in the control groups.


INTRODUCTION
Chronic obstructive pulmonary disease (COPD) is associated with osteoporosis and vertebral fractures. It is still unclear whether the presence of fractures and changes in bone mineral density (BMD) are associated with disease severity and prognosis. The aim of this study was to evaluate BMD and morphometric vertebral fractures (MVF) in COPD patients in comparison with two control groups and to correlate these parameters with indices of COPD severity (VEF1 and GOLD) and prognosis (BODE).


METHODS
This was a cross-sectional study in COPD patients (disease group, DG) who underwent BMD and vertebral fracture assessment (VFA). Two control groups were used: smokers without COPD (smoker group, SG) and healthy never-smoker individuals (never-smoker group, NSG).


RESULTS
The DG comprised 121 patients (65 women, mean age 67.9 ± 8.6 years). Altered BMD was observed in 88.4% of the patients in the DG, which was more prevalent when compared with the control groups (p < 0.001). The BMD values were lower in the DG than in the control groups (p < 0.05). BMD was associated with the worst disease severity and prognosis (p < 0.05). The prevalence of MVF was high (57.8%) and greater than that in the SG (23.8%) and the NSG (14.8%; p < 0.001). The prevalence of fractures was not associated with disease severity and prognosis.


CONCLUSIONS
COPD patients have a higher prevalence of MVF and low BMD, and the latter was associated with the severity and poor prognosis of the disease.
['Munhoz da Rocha Lemos Costa|T|T|', 'Costa|F M|FM|', 'Hoffman Jonasson|T|T|', 'Aguiar Moreira|C|C|', 'Boguszewski|C L|CL|', 'Cunha Borges|J L|JL|', 'Zeghbi Cochenski Borba|V|V|']
D000368:Aged D015519:Bone Density D016022:Case-Control Studies D003430:Cross-Sectional Studies D005260:Female D005269:Femur D005272:Femur Neck D005541:Forced Expiratory Volume D006801:Humans D008159:Lumbar Vertebrae D008297:Male D008875:Middle Aged D010024:Osteoporosis D058866:Osteoporotic Fractures D011379:Prognosis D029424:Pulmonary Disease, Chronic Obstructive D012720:Severity of Illness Index D012907:Smoking D016103:Spinal Fractures
Bone mineral density Vertebral fractures COPD GOLD BODE