The role of COPD in development of osteoporosis

Osteoporosis(OP) is a disease of bone that leads to reduced bone mineral density(BMD) and increased risk of fracture. The development of OP in patients with asthma(A) and COPD is important problem in pulmonology.Aims:to find out the role of COPD and A in the course of the OP.Subjects:In our study were examined 79 women(66,9±1,7y) with a postmenopausal OP which not used oral glucocorticoids(Gks). All subjects were formed 3 groups.1 group-31 non-smokers patient with A(65,9 ±2y); 2-23 current smokers(14±2,2p/y) with COPD(67,7±2,3y). Pulmonary patients received therapy inhaled Gks(average dose1000mkg/day). 3– 25 patients with OP without lung disease(WLD). The mean of groups are shown in table1 Table1 Group/title n Age FEV1% BMD radius T-score radius Forearm fractures Case(%) Vertebral Fractures Case(%) 1 31 65,9±2,0 76,8±3,9 0,63±0,02 -2,80±0,17 51,6 19,3 2 23 67,7±2,3 57,1±3,6¹ 0,57±0,02¹ -3,37±0,18¹ 65,2¹ 34,8 3 25 67,5±2,0 92,9±1,5²´³ 0,63±0,02² -2,67±0,2² 44,0 16,0² Mean values ± SD ¹ p<0.05 compared groups 1 with 2 ² p<0.05 compared groups 2 with 3 ³ p<0.05 compared groups 1 with 3 Results:Compared COPD patients with A patients and patients WLD the means of FEV1, BMD radius, T-score radius are higher in group 1 and 3(p≤0,05). Case of fractures were more often in COPD patients(p≤0,05). There are no significant differences in course of OP between groups 1 and 3.Conclusion:Our result show that course of the OP in COPD patients is more severe. It proved by the significantly lower means of BMD radius, T-score radius and more frequent fractures cases in this group. It demonstrates the impact of systemic inflammation and smoking on the bone metabolism in COPD patients. The influence of using inhaled Gks is not evident in the course of OP in our groups.