Table 3—

Correlates of osteoporosis in chronic obstructive pulmonary disease(COPD)

First author [ref.]Subjects nAge yrsSex M/F nFEV1 % pred#BMI kg·m−2FFMI kg·m−2Dependent variable/ correlation withCovariables/ adjusted forSignificant correlate(s)
Bolton 30586731/275425.617.21OsteoporosisAge, sex, daily dose of inhaled steroids, pack-yrs, FEV1, BMI, SFA FFMI, MAC, %IBWBMI (OR: 0.79), %IBW (OR: 0.93)
Vrieze 201156062/5343.426.417.3Abnormal BMD (T-score <−1 based on QUS)3 models, all adjusted for age and sex: 1) GOLD stages, 2) normal and low FFM, 3) normal and low BMIGOLD III (OR: 2.4), GOLD IV (OR: 7.6), low FFM (OR: 4.9), low BMI (OR: 4.7)
Kjensli 31886457/3144.425.7NA3 models: 1) ZL2–4; 2) ZFN; 3) ZTBBMI and steroid use1) GOLD II–IV (se: 0.3), BMI (se 0.0), steroids (SE 0.1); 2) BMI (se 0.0); 3) BMI (se 0.0)
Mineo 224061Males only1.06 L22.9NA (FFM: 48.6)Increase in lumbar BMDNAΔRV (ρ = −0.51), ΔDL,CO (ρ = 0.52), ΔBMI (ρ = 0.50), ΔFFM (ρ = 0.52), Δbone APH (ρ = −0.42), Δβ-crosslaps+ (ρ = −0.61), Δmethylprednisolone (ρ = −0.41)
Komerik 32306620/10Not shown24.0NAMandibular BMDNASerum calcium(pos corr; r = 0.37), APH (neg corr; r = 0.52)
Bolton 12816643/384424.016.2BMDFFMI, FMI, pack-yrs, age, sex, IL-6, inhaled corticosteroid dose and FEV1FFMI (r2 = 0.60)
Scanlon 3341256217/19569.326.3NAChange in BMD 2 places: 1) FN, 2) LSDrug (ICS versus placebo), age group (≥56 yrs versus <56 yrs), sex, cigarettes a day, calcium use, vitamin D use, multivitamin use1) Drug (ES = −1.72%), age group (ES = −1.14%); 2) drug (ES = −1.21%), sex (ES = −1.19%):
Dubois 24122258666/556NS25.8NA1) LS BMD, 2) TH BMD, 3) FN BMDBMI, FEV1, RV, TLC, treatment group§1) Treatment group 2§ (r = 0.48), 2) BMI(r = 0.65), 3) BMI(r = 0.58)
Katsura 252072Females only5022.0NA1) Total body BMD, 2) LS BMDNA1) BMI (pos corr r = 0.49), 2) BMI (pos corr r = 0.55)
Dimai 277165Males onlyNS25.8NABMDNAPartial correlation coefficient of pH (r not shown)
Incalzi 281047168/36NS26.3NAOsteoporosisAge, male gender, Pa,CO2>6.93 kPa, BMI ≤22 kg·m−2, FEV1/FVC <34%, MAMC <201.34BMI ≤22 kg·m−2 (OR: 4.18)
Bikle 343663Males onlyƒ1.5 LNANABMDNAFEV1 (r = 0.77)
  • M: male; F: female; FEV1: forced expiratory volume in 1 s; % pred: % predicted; BMI: body mass index; FFMI: fat-free mass index; OR: odds ratio; SFA: skinfold anthropometry; MA(M)C: midarm (muscle) circumference; %IBW: % of ideal body weight; BMD: bone mineral density; QUS: quantitative ultrasound; GOLD: Global Initiative for Chronic Obstructive Lung Disease; FFM: fat-free mass; ZL2–4: Z-score at lumbar spine vertebra L2–L4; ZFN: Z-score femoral neck; ZTB: Z-score total body; NA: not assessed or not applicable; Δ: change; RV: residual volume; DL,CO: diffusing capacity of the lung for carbon monoxide; (bone-)APH: (bone-specific) alkaline phosphatase; pos corr: positive correlation; neg corr: negative correlation; IL: interleukin; ICS: inhaled corticosteroids; FN: femoral neck; LS: lumbar spine; ES: effect size; TH: total hip; TLC: total lung capacity; Pa,CO2: arterial carbon dioxide tension; FVC: forced vital capacity. #: FEV1 is in % predicted, with the exception of the data for Mineo 22; :only COPD patients from the lung volume reduction surgery group (no correlation determined in pulmonary rehabilitation group, n = 30); +: cross-linked C-terminal telopeptide of type I collagen; §: group 1: continues oral corticosteroids; group 2: multiple courses of prednisone, cumulative dose ≥1,00 mg; group 3: multiple courses of prednisone, cumulative dose <1,000 mg; group 4: never systemic corticosteroids; ƒ: confirmed by the author.