Table 1—

Epidemiology of osteoporosis and fractures in chronic obstructive pulmonary disease (COPD)

1st author [ref no.]Year of studyPatients' characteristicsNumber of patientsMain outcome
Aris 111996Pretransplantation15Z score >2sd below mean (7 patients)
Shane 121996Pretransplantation2829% prevalence of vertebral fractures
Dubois 132002Continuous (n=11), intermittent (n=38) systemic CS or inhaled CS (n=37)86Osteoporosis: 21% (lumbar spine), 22% (hip) and 28% (femoral neck)
Lung Health Study research Group 142000FEV1 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 151999Smokers with mild COPD randomised to inhaled budesonide or placebo102 (BMD measured) 653 had spine radiographsNo 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 71998FEV1/FVC <70% in 3 groups: 1) no CS; 2) inhaled CS; 3) systemic CS312Prevalence of vertebral fractures (%): 48.7 (group 1), 57.1 (group 2), 63.3 (group 3).
Riancho 161987Mean FEV1 39%, no long-term CS445.3% 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