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Relationship between pulmonary emphysema and osteoporosis assessed by CT in patients with COPD

¹ Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan ² Department of Experimental Therapeutics, Kyoto University, Kyoto, Japan

t_hirai{at}kuhp.kyoto-u.ac.jp

Abstract

BackgroundOsteoporosis is one of the important systemic features of chronic obstructive pulmonary disease (COPD). Although COPD itself is regarded as one risk factor for osteoporosis, the relationship between the extent of emphysema and reduced bone density is still unclear. Our first aim was therefore to measure vertebral bone density and the percentage of low attenuation area in the lungs (LAA%) using chest computed tomography (CT) in COPD patients. Second aim was to investigate the relationships among CT measurements, anthropometric parameters, and pulmonary function.

MethodsChest CT scans and pulmonary function tests were performed on 65 male patients with COPD. Using CT images, CT density of the thoracic and lumbar vertebrae (T4, T7, T10, and L1) and LAA% were measured quantitatively, and their correlations were analyzed.

ResultsLinear regression analyses revealed that LAA% had a significant negative correlation with bone mineral density (r = -0.522). In addition, multiple regression analysis showed that only LAA% and body mass index (BMI) were predictive of bone mineral density among age, BMI, smoking index, forced expiratory volume in 1 second, arterial blood gas and LAA%.

ConclusionsThe extent of pulmonary emphysema significantly correlated with reduced bone density. Our study suggested that COPD itself could be a risk factor for osteoporosis and that chest CT is useful for the management of COPD as a systemic disease.

Key Words: chronic obstructive pulmonary disease • computed tomography • pulmonary emphysema • osteoporosis • bone mineral density