Correlates of osteoporosis in chronic obstructive pulmonary disease

Respir Med. 2000 Nov;94(11):1079-84. doi: 10.1053/rmed.2000.0916.


The aim of this study was to analyse the correlates of reduced bone mineral density in patients with chronic obstructive pulmonary disease (COPD), with special regard to a possible protective role of hypercapnia. One hundred and four consecutive COPD inpatients in stabilized respiratory conditions underwent a comprehensive assessment of their health status. Bone mineral density was measured by X-ray absorptiometry at the lumbar site and at the femoral neck site. Differences in health-related variables between patients with (group O, n=62) and without (group N, n=42) lumbar and/or femoral neck osteoporosis were assessed first by univariate analysis and then by logistic regression analysis aimed to identify independent correlates of osteoporosis. Group O was characterized by worse nutritional status, as reflected by indices exploring either lean or fat mass, and by a trend towards lower forced expiratory volume in 1 sec/forced vital capacity ratio. Arterial tension of carbon dioxide lacked any correlation with bone mineral density. According to the logistic regression analysis, body mass index < or = 22 kg m(-2) qualified as the only and positive independent correlate of osteoporosis (odds ratio=4.18; 95% confidence intervals=1.19-14.71). In conclusion, malnutrition characterizes COPD patients with osteoporosis, while mild to moderate hypercapnia lacks either a positive or negative effect on bone mineral density. Longitudinal studies are needed to identify predictors rather than correlates of bone mineral density.

MeSH terms

  • Absorptiometry, Photon
  • Aged
  • Analysis of Variance
  • Bone Density*
  • Female
  • Femur Neck / physiopathology
  • Humans
  • Hypercapnia / physiopathology
  • Logistic Models
  • Lumbar Vertebrae / physiopathology
  • Lung Diseases, Obstructive / physiopathology*
  • Male
  • Nutrition Disorders / physiopathology*
  • Osteoporosis / physiopathology*
  • Respiratory Function Tests
  • Risk Factors