In which male patients with COPD participated in a pulmonary rehabilitation program should be evaluated for osteoporosis?

Abstract

Osteoporosis is common in patients with COPD and an important risk factor for the development of hip,vertebral or long bone fracture which could add further disability and incapacity.

The aim of the study was to analyze the utility of different measures (age, smoking habit, daily dose of inhaled steroids, anthropometric measures of body composition, stage of COPD, dyspnea, health related quality of life, exercise capacity,comorbidities) for detecting the need of osteoporosis evaluation in male COPD patients who were participated in a PR programme.

Methods: Patients who were in a pulmonary rehabilitation programme with confirmed stable COPD and not on long-term oral corticosteroids (n=57) performed spirometry. They underwent nutritional assessment by midarm circumference,calculation BMI and FFMI. Dyspnea sensation was assessed with the MRC,where health related quality of life was assessed with the SGRQ.Exercise capacity was measured using the SWT.All had DXA assessment of Bone Mineral Density.

Results: A total of 57 COPD patients with the mean age of 62.07±7.5 years. Osteoporosis was found in 22 patients (38.6%) at both the total hip and total lumbar spine region.

After adjusting for all covariates (age, FEV1, daily dose of inhaled steroids and smoking pack years)COPD patients with a lower BMI was found to be at an increased risk of hip region osteoporosis. The adjusted odds ratio for BMI: 0.51 (0.28-0.91), P=0.023.

The addition any of the other measurements was not found as a risk factor for osteoporosis.

Conclusion: Nutritional assessment, incorporating a calculation of their BMI may confer benefit detecting those at risk of osteoporosis in male COPD patients.