Comparison of bone mineral density in elderly female patients with COPD and bronchial asthma
Comparison of bone mineral density in elderly female patients with COPD and bronchial asthma
复制标题
老年女性COPD与支气管哮喘患者骨密度比较
作者：
Katsura;Kida
背景资料：最近的一项研究表明，骨质疏松症和椎体骨折在晚期COPD患者中相当常见，并与这些患者的死亡率有显著关系。这些结果表明，对晚期COPD患者进行骨质疏松症的管理是一项重要的干预措施。但从未接受过慢性全身性皮质类固醇的COPD患者是否有骨质疏松症的高发病率以及这些患者是否需要治疗策略来减少骨质疏松性骨折尚不清楚。此外，尚不清楚COPD患者和支气管哮喘患者之间骨质疏松程度是否存在差异。目的：比较老年女性慢性阻塞性肺疾病（COPD）患者和未接受过长期系统性皮质类固醇激素治疗的支气管哮喘患者的骨质疏松程度和骨代谢指标，探讨影响COPD患者骨代谢的因素。设计：横断面医学调查。患者：共44例老年女性COPD（n 20）或支气管哮喘（n 24）谁没有接受慢性全身性皮质类固醇激素的患者入组（平均SEM年龄，74.6 1.0岁）。测量值：采用双能X线骨密度仪测量全身及腰椎骨密度（BMD），并对两组数据进行比较。此外，还确定了骨量与临床变量之间的相关性。结果如下：以Z值表示腰椎骨密度时，COPD患者的Z值显著低于支气管哮喘患者（P < 0.01）。COPD患者骨质疏松的患病率也明显高于COPD患者（50% vs21%，p < 0.05）。在COPD患者中，体重指数与腰椎（r 0.55，p 0.02）和全身（r 0.49，p 0.03）BMD呈正相关。其他临床、生化和人体测量变量与BMD无关。结论：在老年女性患者中，骨质疏松症在COPD病例中比在支气管哮喘中更常见，即使这些患者没有接受长期全身性皮质类固醇。COPD患者骨质疏松症患病率较高的原因尚不清楚，但应将减少骨质疏松性骨折的预防策略添加到老年COPD患者的管理中。（CHEST 2002; 122：1949 - 1955）
Background: A recent study has shown that osteoporosis and vertebral fractures are quite common in patients with advanced COPD and showed a significant relationship to the mortality of these patients. These results suggested that management of osteoporosis in advanced COPD is an important intervention. But whether patients with COPD who had never received chronic systemic corticosteroids have a high incidence of osteoporosis and whether these patients require treatment strategies to decrease osteoporotic fracture is not yet known. Furthermore, it is unclear whether there are differences in terms of the degree of osteoporosis between patients with COPD and patients with bronchial asthma. Objectives: To compare the degree of osteoporosis and bone metabolism markers between elderly women with COPD and those with bronchial asthma who had never received chronic systemic corticosteroids, and to determine the factors influencing bone metabolism in these patients. Design: Cross-sectional medical survey. Patients: A total of 44 elderly female patients with COPD (n 20) or bronchial asthma (n 24) who had not received chronic systemic corticosteroids were enrolled (mean SEM age, 74.6 1.0 years). Measurements: Total body and lumbar bone mineral density (BMD) were measured by dualenergy x-ray absorptiometry, and the data were compared between the two groups. In addition, the association between bone mass and clinical variables was determined. Results: When lumbar BMD was expressed as a Z score, the Z scores of patients with COPD were significantly lower than those of patients with bronchial asthma (p < 0.01). The prevalence of osteoporosis was also significantly higher in patients with COPD (50% vs 21%, p < 0.05). In patients with COPD, body mass index was positively correlated with BMD in the lumbar spine (r 0.55, p 0.02) and total body (r 0.49, p 0.03). Other clinical, biochemical, and anthropometric variables were not correlated with BMD. Conclusions: In elderly female patients, osteoporosis is more common in cases of COPD than in bronchial asthma, even if these patients had not received long-term systemic corticosteroids. The explanation for the higher prevalence of osteoporosis in COPD is still not known, but preventive strategies to decrease osteoporotic fractures should be added to the management of elderly patients with COPD. (CHEST 2002; 122:1949 –1955)
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DOI：
10.1056/nejm200012283432601
发表时间：
2000-12
期刊：
The New England journal of medicine
影响因子：
--
作者：
R. Wise;J. Connett;G. Weinmann;P. Scanlon;M. Skeans
通讯作者：
R. Wise;J. Connett;G. Weinmann;P. Scanlon;M. Skeans
影响因子：
--
作者：
Kado, DM;Browner, WS;Cummings, SR
通讯作者：
Cummings, SR
影响因子：
4.1
作者：
MANOLAGAS, SC
通讯作者：
MANOLAGAS, SC
DOI：
10.1164/ajrccm.153.2.8564110
发表时间：
1996-02-01
影响因子：
24.7
作者：
deGodoy, I;Donahoe, M;Rogers, RM
通讯作者：
Rogers, RM