Tuberc Respir Dis.  2018 Jan;81(1):73-79. 10.4046/trd.2017.0066.

Osteoporosis in Patients with Asthma–Chronic Obstructive Pulmonary Disease Overlap Syndrome

Affiliations
  • 1Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea. gyhur@korea.ac.kr

Abstract

BACKGROUND
Osteoporosis is a common disease that occurs comorbidly in patients with chronic inflammatory airway diseases, including asthma, chronic obstructive pulmonary disease (COPD), and asthma-COPD overlap syndrome (ACOS). However, the prevalence of osteoporosis in patients with ACOS has not widely been evaluated. Therefore, we investigated the prevalence of osteoporosis and its relationship with the clinical parameters of patients with asthma, COPD, and ACOS.
METHODS
This was a retrospective, cross-sectional study. Bone mineral density (BMD), lung function tests, and disease status evaluations were conducted.
RESULTS
A total of 321 patients were enrolled: 138 with asthma, 46 with ACOS, and 137 with COPD. One hundred and ninety-three patients (60.1%) were diagnosed with osteoporosis (53.6% of asthma, 65.2% of ACOS, and 65.0% of COPD). Patients with ACOS showed a significantly lower BMD and T-score than did those with asthma. In addition to age, sex, and body mass index (BMI), which were previously reported to be associated with BMD, BMD also had a negative correlation with the diagnosis of ACOS, as compared to a diagnosis of asthma, after adjusting for age, sex, BMI, smoking, and inhaled corticosteroid use (p=0.001). Among those patients with COPD and ACOS, BMD was negatively associated with the COPD Assessment Test (CAT) after adjustment (p < 0.001). Inhaled corticosteroid was not associated with the prevalence of osteoporosis and BMD.
CONCLUSION
Patients with ACOS, particularly aged and lean women, should be more carefully monitored for osteoporosis as compared to patients with asthma.

Keyword

Osteoporosis; Bone Mineral Density; Asthma; Pulmonary Disease, Chronic Obstructive; Syndrome

MeSH Terms

Asthma
Body Mass Index
Bone Density
Cross-Sectional Studies
Diagnosis
Female
Humans
Lung Diseases, Obstructive*
Osteoporosis*
Prevalence
Pulmonary Disease, Chronic Obstructive
Respiratory Function Tests
Retrospective Studies
Smoke
Smoking
Smoke

Figure

  • Figure 1 Study protocol. COPD: chronic obstructive pulmonary disease; ACOS: asthma-COPD overlap syndrome.

  • Figure 2 Comparison of bone mineral densities (BMDs) among patients with asthma, asthma–chronic obstructive pulmonary disease overlap syndrome (ACOS), and chronic obstructive pulmonary disease (COPD). *Significant differences between patients with asthma and ACOS. †Significant differences between patients with asthma and COPD.


Cited by  1 articles

Is Osteoporosis a Common Comorbidity in Different Chronic Airway Diseases?
Seung Hyeun Lee
Tuberc Respir Dis. 2018;81(1):88-90.    doi: 10.4046/trd.2017.0116.


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