African Americans and Men with Severe COPD Have a High Prevalence of Osteoporosis
African Americans and Men with Severe COPD Have a High Prevalence of Osteoporosis
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DOI：
10.1080/15412550802363329
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发表时间：
2008-10-01
影响因子：
2.2
通讯作者：
Criner, Gerard J.
中科院分区：
文献类型：
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作者：
Li, Lihua;Brennan, Kathleen J.;Criner, Gerard J.
骨质疏松症是一种非肺部表现，其在严重慢性阻塞性肺疾病（COPD）中的真实患病率尚不确定。我们描述了一个大型的、特征明确的（COPD）队列中骨质疏松症的患病率和危险因素。对179例非选择性COPD患者进行腰椎和髋关节双能X线吸收测定、全肺功能测试、心肺运动试验、6分钟步行距离和人口统计学分析。患者年龄59 - 7岁，吸烟53 - 32包年，FEV 1 26% +/- 9.8，45%目前正在服用泼尼松。97%的患者骨密度测量结果异常; 66%的患者有双能X线吸收测定法定义的骨质疏松症，而31%的患者有骨质减少。男性与女性的骨质疏松症患病率分别为70%和62%（p = 0.33）;两组的骨折率相似。非裔美国人与高加索人的骨质疏松症患病率分别为69%和65%（p = 0.78）。白人的沃德三角T评分显著低于非裔美国人（-2.52 +/-0.96 vs. -2.16 +/-0.91，p = 0.04）。那些骨折的人比那些没有骨折的人服用更高剂量的强的松。单变量分析确定BMI和FVC%为骨质疏松症的预测因子（p = 0.03或0.934，p = 0.006或0.974）。多变量分析显示仅FVC%是显著预测因素（p = 0.006，OR 0.974）。骨质疏松症在重度COPD中非常普遍，并且影响男性和非裔美国人的程度与女性和白人相似。无论种族或性别如何，骨质疏松症都应被视为重度（COPD）。
Osteoporosis is a non-pulmonary manifestation whose true prevalence is uncertain in severe chronic obstructive pulmonary disease (COPD). We describe the prevalence and risk factors for osteoporosis in a large, well characterized (COPD) cohort. Dual energy x-ray absorptiometry of the lumbar spine and hip, full pulmonary function testing, cardiopulmonary exercise test, 6 minute walk distance and demographics were performed in 179 non-selected COPD patients. Patients were 59 7 years old, smoked 53 32 pack years, FEV1 26% +/- 9.8, and 45% were currently taking prednisone. Bone mineral density measurements were abnormal in 97%; 66% had dual energy X-ray absorptiometry defined osteoporosis, while 31% had osteopenia. The prevalence of osteoporosis in males versus females was 70% versus 62% (p = 0.33); both groups had similar fracture rates. The prevalence of osteoporosis in African Americans versus Caucasians was 69% versus 65% (p = 0.78). Caucasians had a significantly lower Ward's Triangle T score than African Americans (-2.52 +/- -0.96 vs. -2.16 +/- -0.91, p = 0.04). Those with bone fractures took higher doses of prednisone than those without fractures. Univariate analysis identified BMI and FVC% as predictors for osteoporosis (p = 0.03 OR 0.934 p = 0.006 OR 0.974). Multivariate analysis revealed only FVC% as a significant predictor (p = 0.006, OR 0.974). Osteoporosis is highly prevalent in severe COPD, and affects males and African Americans to a similar degree as females and Whites. Osteoporosis should be considered in severe (COPD) regardless of race or gender.