COPD, bone metabolism, and osteoporosis

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


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


  • Adrenal Cortex Hormones
  • Bone Density Conservation Agents
  • Vitamin D
  • Calcium