COPD, bone metabolism, and osteoporosis

An Lehouck; Steven Boonen; Marc Decramer; Wim Janssens

doi:10.1378/chest.10-1427

COPD, bone metabolism, and osteoporosis

Chest. 2011 Mar;139(3):648-657. doi: 10.1378/chest.10-1427.

Authors

An Lehouck¹, Steven Boonen², Marc Decramer¹, Wim Janssens³

Affiliations

¹ Respiratory Division, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium.
² Center of Metabolic Bone Diseases, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium.
³ Respiratory Division, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium. Electronic address: wim.janssens@uz.kuleuven.be.

PMID: 21362651
DOI: 10.1378/chest.10-1427

Abstract

COPD and osteoporosis are strongly associated because of common risk factors such as age, smoking, and inactivity. In addition, COPD-related systemic inflammation, vitamin D deficiency, and the use of systemic corticosteroids enhance ongoing bone destruction. Osteoporosis, in turn, may cause fragility fractures, which further impair mobility and increase morbidity and mortality. Vertebral compression fractures and rib cage fractures in patients with COPD may also reduce pulmonary function or enhance exacerbations. Early prevention and treatment of osteoporosis in COPD is, therefore, important and should be based on integrated risk assessment tools such as FRAX, which take bone mineral density, history of fragility fractures, and population-specific clinical factors into account. As long as intervention studies focusing on the bone in COPD are lacking, a more rigorous application of existing treatment guidelines of osteoporosis in general is mandatory.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adrenal Cortex Hormones / adverse effects
Adrenal Cortex Hormones / pharmacology
Adrenal Cortex Hormones / therapeutic use
Bone Density / drug effects
Bone Density Conservation Agents / administration & dosage
Bone Density Conservation Agents / pharmacology
Bone Density Conservation Agents / therapeutic use
Bone and Bones / metabolism*
Calcium / administration & dosage
Calcium / pharmacology
Calcium / therapeutic use
Dietary Supplements
Fractures, Bone / epidemiology
Humans
Osteoporosis / epidemiology*
Osteoporosis / metabolism*
Osteoporosis / prevention & control
Prevalence
Pulmonary Disease, Chronic Obstructive / complications*
Pulmonary Disease, Chronic Obstructive / drug therapy
Pulmonary Disease, Chronic Obstructive / metabolism*
Risk Factors
Vitamin D / administration & dosage
Vitamin D / therapeutic use
Vitamin D Deficiency / complications
Vitamin D Deficiency / drug therapy
Vitamin D Deficiency / metabolism

Substances

Adrenal Cortex Hormones
Bone Density Conservation Agents
Vitamin D
Calcium