Epidemiology of osteoporosis and fractures in chronic obstructive pulmonary disease (COPD)
| 1st author [ref no.] | Year of study | Patients' characteristics | Number of patients | Main outcome |
| Aris 11 | 1996 | Pretransplantation | 15 | Z score >2sd below mean (7 patients) |
| Shane 12 | 1996 | Pretransplantation | 28 | 29% prevalence of vertebral fractures |
| Dubois 13 | 2002 | Continuous (n=11), intermittent (n=38) systemic CS or inhaled CS (n=37) | 86 | Osteoporosis: 21% (lumbar spine), 22% (hip) and 28% (femoral neck) |
| Lung Health Study research Group 14 | 2000 | FEV1 range 30–90% pred; inhaled triamcinolone (n=158) or placebo (n=170) | 412 (BMD measured) | BMD reduction over 3 yrs greater at lumbar spine and femoral neck for triamcinolone than for placebo. |
| Pauwels 15 | 1999 | Smokers with mild COPD randomised to inhaled budesonide or placebo | 102 (BMD measured) 653 had spine radiographs | No greater BMD decline over 3 yrs in the budesonide group compared to placebo. |
| At least 1 vertebral fracture in 13.4% (budesonide) and 11.5% (placebo). | ||||
| McEvoy 7 | 1998 | FEV1/FVC <70% in 3 groups: 1) no CS; 2) inhaled CS; 3) systemic CS | 312 | Prevalence of vertebral fractures (%): 48.7 (group 1), 57.1 (group 2), 63.3 (group 3). |
| Riancho 16 | 1987 | Mean FEV1 39%, no long-term CS | 44 | 5.3% wedged vertebra (>30% height loss), not different from the control group (7.4%). |
CS: corticosteroids
FEV1: forced expiratory volume in one second
FVC: forced vital capacity
BMD: bone mineral density
pred: predicted