A review of literature revealed that osteoporosis is common in patients with COPD.
The review was completed by Daisuke Inoue, MD, of the Division of Endocrinology and Metabolism, Third Department of Medicine, Teikyo University, Chiba Medical Center, in Chiba, Japan and colleagues, and was published in the International Journal of COPD on March 29, 2016.
The researchers found one large study of osteoporosis, GLOW, in which 6.2% of the participants sustained a clinical fracture in the course of 2 years. COPD was found to be one of the most significant comorbidities in those who suffered fractures. Other, similar results were seen in studies from around the world. Although studies involving bone mass density in women with COPD have not shown a conclusive link, the researchers say, “bone biopsy is by far the best way to directly assess bone microarchitecture at the tissue level,” and that connectivity density has been found to be negatively correlated with smoking.
“Mechanisms by which osteoporosis occurs in COPD patients are mostly unknown,” according to the authors. They go on to say that “older age and smoking are common risk factors for osteoporosis and COPD.” Another possibility is that the systemic inflammation that characterizes COPD could be a potential cause of COPD-related osteoporosis, as could pulmonary dysfunction.
The researchers note that “Vitamin D deficiency has been shown to be highly prevalent in COPD.” Vitamin D deficiency results in less calcium absorption and in greater risk of fracture. The studies the researchers reviewed “support a role for vitamin D insufficiency/deficiency in COPD-associated osteoporosis, but its contribution to the fracture risk in COPD patients should be more precisely evaluated in a larger prospective study in the future.”