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Title: Impact of COPD exacerbations on osteoporosis assessed by chest CT scan.
Authors: Kiyokawa, Hirofumi
Muro, Shigeo  kyouindb  KAKEN_id
Oguma, Tsuyoshi  kyouindb  KAKEN_id
Sato, Susumu  kyouindb  KAKEN_id  orcid (unconfirmed)
Tanabe, Naoya  kyouindb  KAKEN_id
Takahashi, Tamaki
Kudo, Megumi
Kinose, Daisuke
Kondoh, Hiroshi  kyouindb  KAKEN_id
Kubo, Takeshi  kyouindb  KAKEN_id
Hoshino, Yuma
Ogawa, Emiko
Hirai, Toyohiro  kyouindb  KAKEN_id
Mishima, Michiaki
Author's alias: 室, 繁郎
Keywords: Exacerbation
Bone mineral density
Chronic obstmetive pulmonary disease
Issue Date: Jun-2012
Publisher: Informa Healthcare
Journal title: COPD: Journal of Chronic Obstructive Pulmonary Disease
Volume: 9
Issue: 3
Start page: 235
End page: 242
Abstract: Background: COPD pathology involves not only the lungs but also extrapulmonary abnormalities. Osteoporosis is one of the most important abnormalities because it may cause vertebral compression fractures and deteriorate pulmonary function. COPD patients have many risk factors for osteoporosis, such as low BMI, decreased activity, systemic infl ammation, and use of corticosteroids. Some of these factors have been shown to deteriorate with COPD exacerbations. We previously demonstrated the correlation between emphysema and osteoporosis and between emphysema progression and COPD exacerbations. Thus, the hypothesis that exacerbation causes osteoporosis progression in COPD patients was investigated. Methods: Forty-two COPD patients not on osteoporosis treatment for over 2 years were recruited. During follow-up, exacerbations had been prospectively recorded. Thoracic vertebral bone mineral density (BMD) was measured using chest CT, and the annual change in BMD was calculated. The change was compared between patients with and without a history of exacerbations. Results: The decrease in thoracic vertebral BMD was greater in patients with than in those without a history of exacerbations (median ΔBMD mg/ml⋅year: –3.78 versus –0.30, p = 0.02). Moreover, multivariate regression analysis showed that exacerbations and baseline PaO 2 were independent predictors of the BMD decrease (R 2 = 0.20, p = 0.007, and R 2 = 0.09, p = 0.03, respectively) after adjustment for baseline age, smoking status, and airfl ow limitation. Conclusions: This is the fi rst longitudinal study to demonstrate that COPD exacerbations are independently associated with osteoporosis progression. Osteoporosis progression should be evaluated in COPD patients, especially in those with a history of frequent exacerbations.
Rights: © Informa Healthcare USA, Inc.
DOI(Published Version): 10.3109/15412555.2011.650243
PubMed ID: 22360380
Appears in Collections:Journal Articles

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