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Osteoporosis Associated with Chronic Obstructive Pulmonary Disease

Ryo Okazaki|Reiko Watanabe|Daisuke Inoue
대한골대사학회 (The Korean Society of Bone Metabolism)|2016.08|대한골대사학회지 (Journal of Bone Metabolism)|제23권 제3호|pp. 111-120|DOI http://dx.doi.org/10.11005/jbm.2016.23.3.111

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키워드

SmokingOsteoporosisBone mineral densityFractures bonePulmonary disease chronic obstructive
주제분류정형외과학

초록

Recent epidemiological studies have revealed that osteoporosis is closely associated with common chronic diseases including diabetes, hypertension, chronic kidney disorders, and chronic obstructive pulmonary disease (COPD). COPD is a chronic inflammatory airway disease but now well known to be associated with various systemic comorbidities including osteoporosis. Osteoporosis and osteoporotic fractures are extremely common in COPD patients, which have significant impacts on their quality of life (QOL), activities of daily life (ADL), respiratory function, and possibly their prognosis. COPD-associated osteoporosis is however extremely under-recognized, hence undertreated. Recent studies have suggested that both decreased bone mineral density (BMD) and impaired bone quality compromise bone strength causing fractures in COPD. In COPD patients, various general clinical risk factors for osteoporosis are present including smoking, older age, low body weight, and physical inactivity. In addition, disease-related risk factors such as decreased pulmonary function, inflammation, glucocorticoid use and vitamin D deficiency/insufficiency have been linked to the development of osteoporosis in COPD. Increased awareness of osteoporosis in COPD, especially that of high prevalence of vertebral fractures is called upon among general physicians as well as pulmonologists. Routine screening for osteoporosis and risk assessment of fractures will enable physicians to diagnose COPD patients with comorbid osteoporosis at an early stage. Timely prevention of developing osteoporosis together with appropriate treatment of established osteoporosis may improve QOL and ADL of the COPD patients, preserve their lung function and eventually result in better prognosis in these patients.

Abstract

Recent epidemiological studies have revealed that osteoporosis is closely associated with common chronic diseases including diabetes, hypertension, chronic kidney disorders, and chronic obstructive pulmonary disease (COPD). COPD is a chronic inflammatory airway disease but now well known to be associated with various systemic comorbidities including osteoporosis. Osteoporosis and osteoporotic fractures are extremely common in COPD patients, which have significant impacts on their quality of life (QOL), activities of daily life (ADL), respiratory function, and possibly their prognosis. COPD-associated osteoporosis is however extremely under-recognized, hence undertreated. Recent studies have suggested that both decreased bone mineral density (BMD) and impaired bone quality compromise bone strength causing fractures in COPD. In COPD patients, various general clinical risk factors for osteoporosis are present including smoking, older age, low body weight, and physical inactivity. In addition, disease-related risk factors such as decreased pulmonary function, inflammation, glucocorticoid use and vitamin D deficiency/insufficiency have been linked to the development of osteoporosis in COPD. Increased awareness of osteoporosis in COPD, especially that of high prevalence of vertebral fractures is called upon among general physicians as well as pulmonologists. Routine screening for osteoporosis and risk assessment of fractures will enable physicians to diagnose COPD patients with comorbid osteoporosis at an early stage. Timely prevention of developing osteoporosis together with appropriate treatment of established osteoporosis may improve QOL and ADL of the COPD patients, preserve their lung function and eventually result in better prognosis in these patients.

참고문헌 (100)

  1. Sarkar M, "Osteoporosis in chronic obstructive pulmonary disease", Clin Med Insights Circ Respir Pulm Med, 9, pp.5~21 (2015)
  2. Decramer M, "Chronic obstructive pulmonary disease", Lancet, 379, pp.1341~1351 (2012)
  3. Burgel PR, "Impact of comorbidities on COPD-specific health-related quality of life", Respir Med, 107, pp.233~241 (2013)
  4. Frei A, "Five comorbidities reflected the health status in patients with chronic obstructive pulmonary disease : the newly developed COMCOLD index", J Clin Epidemiol, 67, pp.904~911 (2014)
  5. Graat-Verboom L, "Current status of research on osteoporosis in COPD : a systematic review", Eur Respir J, 34, pp.209~218 (2009)
  6. Kjensli A, "High prevalence of vertebral deformities in COPD patients : relationship to disease severity", Eur Respir J, 33, pp.1018~1024 (2009)
  7. Lehouck A, "COPD, bone metabolism, and osteoporosis", Chest, 139, pp.648~657 (2011)
  8. Graat-Verboom L, "Osteoporosis in COPD outpatients based on bone mineral density and vertebral fractures", J Bone Miner Res, 26, pp.561~568 (2011)
  9. Regan E, "It's the fracture that matters-bone disease in COPD patients", Copd, 9, pp.319~321 (2012)
  10. Watanabe R, "Osteoporosis is highly prevalent in Japanese males with chronic obstructive pulmonary disease and is associated with deteriorated pulmonary function", J Bone Miner Metab, 33, pp.392~400 (2015)
  11. Ryan CS, "Osteoporosis in men : the value of laboratory testing", Osteoporos Int, 22, pp.1845~1853 (2011)
  12. Carter JD, "The recognition and treatment of vertebral fractures in males with chronic obstructive pulmonary disease", Respir Med, 102, pp.1165~1172 (2008)
  13. Majumdar SR, "Prevalence and predictors of vertebral fracture in patients with chronic obstructive pulmonary disease", Respir Med, 104, pp.260~266 (2010)
  14. NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy, "Osteoporosis prevention, diagnosis, and therapy", JAMA, 285, pp.785~795 (2001)
  15. Aris RM, "Severe osteoporosis before and after lung transplantation", Chest, 109, pp.1176~1183 (1996)
  16. Incalzi RA, "Correlates of osteoporosis in chronic obstructive pulmonary disease", Respir Med, 94, pp.1079~1084 (2000)
  17. Dimai HP, "Bone loss in patients with untreated chronic obstructive pulmonary disease is mediated by an increase in bone resorption associated with hypercapnia", J Bone Miner Res, 16, pp.2132~2141 (2001)
  18. Dubois EF, "Dual energy X-ray absorptiometry outcomes in male COPD patients after treatment with different glucocorticoid regimens", Chest, 121, pp.1456~1463 (2002)
  19. Tschopp O, "Osteoporosis before lung transplantation: association with low body mass index, but not with underlying disease", Am J Transplant, 2, pp.167~172 (2002)
  20. Katsura H, "A comparison of bone mineral density in elderly female patients with COPD and bronchial asthma", Chest, 122, pp.1949~1955 (2002)
  21. Karadag F, "Should COPD patients be routinely evaluated for bone mineral density?", J Bone Miner Metab, 21, pp.242~246 (2003)
  22. Bolton CE, "Associated loss of fat-free mass and bone mineral density in chronic obstructive pulmonary disease", Am J Respir Crit Care Med, 170, pp.1286~1293 (2004)
  23. Førli L, "Cytokines, bone turnover markers and weight change in candidates for lung transplantation", Pulm Pharmacol Ther, 21, pp.188~195 (2008)
  24. Mineo TC, "Bone mineral density improvement after lung volume reduction surgery for severe emphysema", Chest, 127, pp.1960~1966 (2005)
  25. Jørgensen NR, "The prevalence of osteoporosis in patients with chronic obstructive pulmonary disease : a cross sectional study", Respir Med, 101, pp.177~185 (2007)
  26. Sabit R, "Arterial stiffness and osteoporosis in chronic obstructive pulmonary disease", Am J Respir Crit Care Med, 175, pp.1259~1265 (2007)
  27. Vrieze A, "Low bone mineral density in COPD patients related to worse lung function, low weight and decreased fat-free mass", Osteoporos Int, 18, pp.1197~1202 (2007)
  28. Ferguson GT, "Prevalence and progression of osteoporosis in patients with COPD : results from the TOwards a Revolution in COPD Health study", Chest, 136, pp.1456~1465 (2009)
  29. Silva DR, "Osteoporosis prevalence and associated factors in patients with COPD : a cross-sectional study", Respir Care, 56, pp.961~968 (2011)
  30. Schnell K, "The prevalence of clinically-relevant comorbid conditions in patients with physician-diagnosed COPD : a cross-sectional study using data from NHANES 1999-2008", BMC Pulm Med, 12, pp.26~ (2012)
  31. Hattiholi J, "Prevalence and correlates of osteoporosis in chronic obstructive pulmonary disease patients in India", Lung India, 31, pp.221~227 (2014)
  32. Dam TT, "Bone mineral density and fractures in older men with chronic obstructive pulmonary disease or asthma", Osteoporos Int, 21, pp.1341~1349 (2010)
  33. Chen SJ, "Chronic obstructive pulmonary disease and allied conditions is a strong independent risk factor for osteoporosis and pathologic fractures : a population-based cohort study", QJM, 108, pp.633~640 (2015)
  34. McEvoy CE, "Association between corticosteroid use and vertebral fractures in older men with chronic obstructive pulmonary disease", Am J Respir Crit Care Med, 157, pp.704~709 (1998)
  35. Papaioannou A, "Prevalence of vertebral fractures among patients with chronic obstructive pulmonary disease in Canada", Osteoporos Int, 14, pp.913~917 (2003)
  36. Nuti R, "Vertebral fractures in patients with chronic obstructive pulmonary disease : the EOLO Study", Osteoporos Int, 20, pp.989~998 (2009)
  37. Ogura-Tomomatsu H, "Predictors of osteoporosis and vertebral fractures in patients presenting with moderate-to-severe chronic obstructive lung disease", Copd, 9, pp.332~337 (2012)
  38. Dennison EM, "Effect of co-morbidities on fracture risk : findings from the Global Longitudinal Study of Osteoporosis in Women(GLOW)", Bone, 50, pp.1288~1293 (2012)
  39. de Vries F, "Severity of obstructive airway disease and risk of osteoporotic fracture", Eur Respir J, 25, pp.879~884 (2005)
  40. Hippisley-Cox J, "Derivation and validation of updated QFracture algorithm to predict risk of osteoporotic fracture in primary care in the United Kingdom: prospective open cohort study", BMJ, 344, pp.e3427~ (2012)
  41. Vestergaard P, "Fracture risk in patients with chronic lung diseases treated with bronchodilator drugs and inhaled and oral corticosteroids", Chest, 132, pp.1599~1607 (2007)
  42. Regan EA, "Improving hip fractures outcomes for COPD patients", Copd, 10, pp.11~19 (2013)
  43. Van Staa TP, "Bone density threshold and other predictors of vertebral fracture in patients receiving oral glucocorticoid therapy", Arthritis Rheum, 48, pp.3224~3229 (2003)
  44. Vestergaard P, "Discrepancies in bone mineral density and fracture risk in patients with type 1 and type 2 diabetes--a meta-analysis", Osteoporos Int, 18, pp.427~444 (2007)
  45. Unnanuntana A, "Diseases affecting bone quality : beyond osteoporosis", Clin Orthop Relat Res, 469, pp.2194~2206 (2011)
  46. Kulak CA, "Skeletal microstructural abnormalities in postmenopausal women with chronic obstructive pulmonary disease", J Bone Miner Res, 25, pp.1931~1940 (2010)
  47. Silva BC, "Trabecular bone score : a noninvasive analytical method based upon the DXA image", J Bone Miner Res, 29, pp.518~530 (2014)
  48. Leslie WD, "Clinical factors associated with trabecular bone score", J Clin Densitom, 16, pp.374~379 (2013)
  49. Romme EA, "Bone stiffness and failure load are related with clinical parameters in men with chronic obstructive pulmonary disease", J Bone Miner Res, 28, pp.2186~2193 (2013)
  50. Link TM, "Osteoporosis imaging : state of the art and advanced imaging", Radiology, 263, pp.3~17 (2012)
  51. Naylor K, "Bone turnover markers : use in osteoporosis", Nat Rev Rheumatol, 8, pp.379~389 (2012)
  52. Duckers JM, "Low bone mineral density in men with chronic obstructive pulmonary disease", Respir Res, 12, pp.101~ (2011)
  53. Xiaomei W, "Bone metabolism status and associated risk factors in elderly patients with chronic obstructive pulmonary disease(COPD)", Cell Biochem Biophys, 70, pp.129~134 (2014)
  54. Romme EA, "Osteoporosis in chronic obstructive pulmonary disease", Expert Rev Respir Med, 7, pp.397~410 (2013)
  55. Ward KD, "A meta-analysis of the effects of cigarette smoking on bone mineral density", Calcif Tissue Int, 68, pp.259~270 (2001)
  56. Kanis JA, "Smoking and fracture risk : a meta-analysis", Osteoporos Int, 16, pp.155~162 (2005)
  57. Boyer L, "Aging-related systemic manifestations in COPD patients and cigarette smokers", PLoS One, 10, pp.e0121539~ (2015)
  58. Jaramillo JD, "Reduced Bone Density and Vertebral Fractures in Smokers. Men and COPD Patients at Increased Risk", Ann Am Thorac Soc, 12, pp.648~656 (2015)
  59. Vestbo J, "Body mass, fat-free body mass, and prognosis in patients with chronic obstructive pulmonary disease from a random population sample: findings from the Copenhagen City Heart Study", Am J Respir Crit Care Med, 173, pp.79~83 (2006)
  60. De Laet C, "Body mass index as a predictor of fracture risk : a meta-analysis", Osteoporos Int, 16, pp.1330~1338 (2005)
  61. Remels AH, "The mechanisms of cachexia underlying muscle dysfunction in COPD", J Appl Physiol, 114, pp.1253~1262 (2013)
  62. Nguyen TV, "Osteoporosis in elderly men and women: effects of dietary calcium, physical activity, and body mass index", J Bone Miner Res, 15, pp.322~331 (2000)
  63. Johansson J, "Objectively measured physical activity is associated with parameters of bone in 70-year-old men and women", Bone, 81, pp.72~79 (2015)
  64. Miller J, "Comorbidity, systemic inflammation and outcomes in the ECLIPSE cohort", Respir Med, 107, pp.1376~1384 (2013)
  65. Tsuda T, "Development of the Japanese version of the COPD Assessment Test", Respir Investig, 50, pp.34~39 (2012)
  66. Kanis JA, "FRAX and its applications to clinical practice", Bone, 44, pp.734~743 (2009)
  67. Barnes PJ, "Mediators of chronic obstructive pulmonary disease", Pharmacol Rev, 56, pp.515~548 (2004)
  68. Sinden NJ, "Systemic inflammation and comorbidity in COPD : a result of 'overspill' of inflammatory mediators from the lungs? Review of the evidence", Thorax, 65, pp.930~936 (2010)
  69. Hoepers AT, "Systematic review of anaemia and inflammatory markers in chronic obstructive pulmonary disease", Clin Exp Pharmacol Physiol, 42, pp.231~239 (2015)
  70. Eagan TM, "Systemic inflammatory markers in COPD : results from the Bergen COPD Cohort Study", Eur Respir J, 35, pp.540~548 (2010)
  71. Bade G, "Serum cytokine profiling and enrichment analysis reveal the involvement of immunological and inflammatory pathways in stable patients with chronic obstructive pulmonary disease", Int J Chron Obstruct Pulmon Dis, 9, pp.759~773 (2014)
  72. Tomiyama H, "Elevated C-reactive protein : a common marker for atherosclerotic cardiovascular risk and subclinical stages of pulmonary dysfunction and osteopenia in a healthy population", Atherosclerosis, 178, pp.187~192 (2005)
  73. Koh JM, "Higher circulating hsCRP levels are associated with lower bone mineral density in healthy pre-and postmenopausal women : evidence for a link between systemic inflammation and osteoporosis", Osteoporos Int, 16, pp.1263~1271 (2005)
  74. Kim BJ, "Relationship between serum hsCRP concentration and biochemical bone turnover markers in healthy pre-and postmenopausal women", Clin Endocrinol, 67, pp.152~158 (2007)
  75. de Pablo P, "Association between bone mineral density and C-reactive protein in a large population-based sample", Arthritis Rheum, 64, pp.2624~2631 (2012)
  76. Ahmadi-Abhari S, "C-reactive protein and fracture risk : European prospective investigation into Cancer Norfolk Study", Bone, 56, pp.67~72 (2013)
  77. Berglundh S, "C-reactive protein, bone loss, fracture, and mortality in elderly women: a longitudinal study in the OPRA cohort", Osteoporos Int, 26, pp.727~735 (2015)
  78. Bai P, "Disturbance of the OPG", RANK, Respir Res, pp.2011, 12[DOI]
  79. Liang B, "The association of low bone mineral density with systemic inflammation in clinically stable COPD", Endocrine, 42, pp.190~195 (2012)
  80. Arnett TR, "Acidosis, hypoxia and bone", Arch Biochem Biophys, 503, pp.103~109 (2010)
  81. Choi JW, "Association between respiratory function and osteoporosis in pre-and postmenopausal women", Maturitas, 48, pp.253~258 (2004)
  82. Jeon YK, "The relationship between pulmonary function and bone mineral density in healthy nonsmoking women : the Korean National Health and Nutrition Examination Survey(KNHANES)2010", Osteoporos Int, 25, pp.1571~1576 (2014)
  83. Dennison EM, "Is lung function associated with bone mineral density? Results from the Hertfordshire Cohort Study", Arch Osteoporos, 8, pp.115~ (2013)
  84. Lange P, "Lung-Function Trajectories Leading to Chronic Obstructive Pulmonary Disease", N Engl J Med, 373, pp.111~122 (2015)
  85. Harrison RA, "Osteoporosis-related kyphosis and impairments in pulmonary function : a systematic review", J Bone Miner Res, 22, pp.447~457 (2007)
  86. Graat-Verboom L, "Progression of osteoporosis in patients with COPD : a 3-year follow up study", Respir Med, 106, pp.861~870 (2012)
  87. van Staa TP, "Oral corticosteroids and fracture risk : relationship to daily and cumulative doses", Rheumatology, 39, pp.1383~1389 (2000)
  88. Ton FN, "Effects of low-dose prednisone on bone metabolism", J Bone Miner Res, 20, pp.464~470 (2005)
  89. Mathioudakis AG, "Impact of long-term treatment with low-dose inhaled corticosteroids on the bone mineral density of chronic obstructive pulmonary disease patients: aggravating or beneficial?", Respirology, 18, pp.147~153 (2013)
  90. Holick MF, "Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline", J Clin Endocrinol Metab, 96, pp.1911~1930 (2011)
  91. Ebeling PR, "Vitamin D and bone health : Epidemiologic studies", Bonekey Rep, 3, pp.511~ (2014)
  92. Førli L, "Vitamin D deficiency, bone mineral density and weight in patients with advanced pulmonary disease", J Intern Med, 256, pp.56~62 (2004)
  93. Romme EA, "Vitamin D status is associated with bone mineral density and functional exercise capacity in patients with chronic obstructive pulmonary disease", Ann Med, 45, pp.91~96 (2013)
  94. Janssens W, "Vitamin D deficiency is highly prevalent in COPD and correlates with variants in the vitamin D-binding gene", Thorax, 65, pp.215~220 (2010)
  95. Persson LJ, "Chronic obstructive pulmonary disease is associated with low levels of vitamin D", PLoS One, 7, pp.e38934~ (2012)
  96. Zhu B, "Vitamin D deficiency is associated with the severity of COPD : a systematic review and meta-analysis", Int J Chron Obstruct Pulmon Dis, 10, pp.1907~1916 (2015)
  97. Brot C, "The influence of smoking on vitamin D status and calcium metabolism", Eur J Clin Nutr, 53, pp.920~926 (1999)
  98. Janssens W, "Vitamin D and chronic obstructive pulmonary disease: hype or reality?", Lancet Respir Med, 1, pp.804~812 (2013)
  99. Martineau AR, "Vitamin D3 supplementation in patients with chronic obstructive pulmonary disease (ViDiCO): a multicentre, double-blind, randomised controlled trial", Lancet Respir Med, 3, pp.120~130 (2015)
  100. Inoue D, "COPD and osteoporosis: links, risks, and treatment challenges", Int J Chron Obstruct Pulmon Dis, 11, pp.637~648 (2016)

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