Impact of COPD exacerbations on osteoporosis assessed by chest CT scan.
Impact of COPD exacerbations on osteoporosis assessed by chest CT scan.
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DOI：
10.3109/15412555.2011.650243
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发表时间：
2012-06
期刊：
影响因子：
2.2
通讯作者：
Mishima M
中科院分区：
文献类型：
--
作者：
Kiyokawa H;Muro S;Oguma T;Sato S;Tanabe N;Takahashi T;Kudo M;Kinose D;Kondoh H;Kubo T;Hoshino Y;Ogawa E;Hirai T;Mishima M
背景：慢性阻塞性肺病病理不仅涉及肺，而且涉及肺外异常。骨质疏松症是最重要的异常之一，因为它可能导致椎体压缩性骨折和肺功能恶化。COPD患者有许多骨质疏松的危险因素，如低BMI，活动减少，全身性炎症和使用皮质类固醇。其中一些因素已被证明会随着慢性阻塞性肺病的恶化而恶化。我们之前证明了肺气肿与骨质疏松症以及肺气肿进展与COPD恶化之间的相关性。因此，加重导致COPD患者骨质疏松进展的假说被研究。方法：招募42例2年以上未接受骨质疏松治疗的COPD患者。随访期间，对病情恶化进行前瞻性记录。采用胸部CT测量胸椎骨密度（BMD），并计算BMD的年变化。比较有和没有病情加重史的患者的变化。结果：有加重史的患者胸椎骨密度下降幅度大于无加重史的患者（中位ABMD mg/ml年：- 3.78 vs - 0.30, p = 0.02）。此外，多因素回归分析显示，在调整基线年龄、吸烟状况和气流限制后，病情加重和基线Pa02是BMD下降的独立预测因子（R2 = 0.20, p = 0.007, R2 = 0.09, p = 0.03）。结论：这是第一个证明COPD恶化与骨质疏松进展独立相关的纵向研究。骨质疏松的进展应该在COPD患者中进行评估，特别是那些有频繁恶化史的患者。
Background: COPD pathology involves not only the lungs but also extrapulmonary abnormalities. Osteoporosis is one of the most important abnormalities because it may cause vertebral compression fractures and deteriorate pulmonary function. COPD patients have many risk factors for osteoporosis, such as low BMI, decreased activity, systemic inflammation, and use of corticosteroids. Some of these factors have been shown to deteriorate with COPD exacerbations. We previously demonstrated the correlation between emphysema and osteoporosis and between emphysema progression and COPD exacerbations. Thus, the hypothesis that exacerbation causes osteoporosis progression in COPD patients was investigated. Methods: Forty-two COPD patients not on osteoporosis treatment for over 2 years were recruited. During follow-up, exacerbations had been prospectively recorded. Thoracic vertebral bone mineral density (BMD) was measured using chest CT, and the annual change in BMD was calculated. The change was compared between patients with and without a history of exacerbations. Results: The decrease in thoracic vertebral BMD was greater in patients with than in those without a history of exacerbations (median ABMD mg/ml year: −3.78 versus −0.30, p = 0.02). Moreover, multivariate regression analysis showed that exacerbations and baseline Pa02 were independent predictors of the BMD decrease (R2 = 0.20, p = 0.007, and R2 = 0.09, p = 0.03, respectively) after adjustment for baseline age, smoking status, and airflow limitation. Conclusions: This is the first longitudinal study to demonstrate that COPD exacerbations are independently associated with osteoporosis progression. Osteoporosis progression should be evaluated in COPD patients, especially in those with a history of frequent exacerbations.
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DOI：
10.1073/pnas.96.16.8829
发表时间：
1999-08-03
影响因子：
11.1
作者：
Mishima, M;Hirai, T;Suki, B
通讯作者：
Suki, B
DOI：
10.1164/rccm.200406-754oc
发表时间：
2004-12-15
影响因子：
24.7
作者：
Bolton, CE;Ionescu, AA;Shale, DJ
通讯作者：
Shale, DJ
影响因子：
9.6
作者：
Cote, Claudia G.;Dordelly, Luis J.;Celli, Bartolome R.
通讯作者：
Celli, Bartolome R.
影响因子：
4.3
作者：
Groenewegen, Karin H.;Dentener, Mieke A.;Wouters, Erniel F. M.
通讯作者：
Wouters, Erniel F. M.
影响因子：
6.2
作者：
Harrison, Robyn A.;Siminoski, Kerry;Majumdar, Sumit R.
通讯作者：
Majumdar, Sumit R.