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Current status of research on osteoporosis in COPD: a systematic review

¹ Dept of Respiratory Medicine, Catharina Hospital Eindhoven, Eindhoven, ² Dept of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, ³ Dept of Research, Development & Education, Centre for Integrated Rehabilitation of Organ failure (CIRO), Horn, and ⁴ Dept of Respiratory Medicine, St Jans Gasthuis, Weert, The Netherlands.

CORRESPONDENCE: L. Graat-Verboom, Dept of Respiratory Medicine, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands. E-mail: lidwiengraat{at}versatel.nl

Keywords: Bone loss, bone mineral density, chronic obstructive pulmonary disease, pharmacotherapy, systemic effects

Received: August 24, 2008
Accepted December 22, 2008

Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of osteoporosis. However, the prevalence, correlates and effectiveness of treatment of osteoporosis in COPD patients remain unclear.

We performed a systematic review of the literature to answer three questions. 1) What is the prevalence of osteoporosis in COPD? 2) What are identified correlates of osteoporosis in COPD? 3) What are the effects of treatment of osteoporosis in COPD? A computerised literature search in MEDLINE/PubMed and the Cochrane database was carried out. In addition, reference lists were searched by hand and authors were contacted if necessary.

The prevalence of osteoporosis and osteopenia varied 9–69% and 27–67%, respectively. Prevalence of osteoporosis was generally higher than in healthy subjects and some other chronic lung diseases. Correlates of osteoporosis in COPD are mainly measures of body composition, disease severity and the use of corticosteroids, although causality has not been proven. Effects of treatment of osteoporosis have not been investigated in samples consisting of COPD patients only.

Longitudinal follow-up to assess determinants of osteoporosis in COPD and randomised placebo-controlled trials on the effects of treatment of osteoporosis in patients with COPD only are warranted.