Osteoporos Sarcopenia.  2020 Dec;6(4):179-187. 10.1016/j.afos.2020.11.003.

Chronic obstructive pulmonary disease severity in middle-aged and older men with steoporosis associates with decreased bone formation

Affiliations
  • 1Department of Orthopedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
  • 2Department of Orthopedic Surgery, Shin-Kokura Hospital, Federation of National Public Service, Kitakyushu, Japan
  • 3Shared-Use Research Center, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
  • 4Department of Thoracic Surgery, Shin-Kokura Hospital, Federation of National Public Service, Kitakyushu, Japan
  • 5Department of Respiratory Medicine, Shin-Kokura Hospital, Federation of National Public Service, Kitakyushu, Japan
  • 6Department of Respiratory Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan

Abstract


Objectives
Chronic obstructive pulmonary disease (COPD) is a risk factor for osteoporosis. Nevertheless, much remains unclear regarding the bone metabolism dynamics associated with COPD. The present study focuses on the associations between the COPD severity and serum bone metabolism biomarkers.
Methods
We enrolled 40 patients who visited the orthopedics departments at our institutions and underwent dual-energy X-ray absorptiometry between September 2015 and December 2017. Only male osteoporosis patients over 45 years of age were included, and 5 patients were excluded due to disease or use of internal medicines affecting bone metabolism. All subjects underwent lung function testing, spine radiography, and blood tests. We measured percent forced expiratory volume in 1 second (%FEV1), which reflects COPD severity, and we examined the relationships between %FEV1and serum levels of bone metabolism biomarkers.
Results
All subjects were diagnosed with osteoporosis based on T-scores. %FEV1 correlated with body weight, body mass index (BMI), and Z-score/T-scores. %FEV1 moderately correlated with serum levels of alkaline phosphatase (ALP), procollagen type 1 N-terminal propeptide (P1NP), and tartrate-resistant acid phosphatase 5b in the partial correlation analysis adjusted for BMI or T-score in the lumbar vertebrae. We performed a hierarchical multiple regression analysis to identify that serum ALP and P1NP were the independent explanatory variables to %FEV1 independent of other factors.
Conclusions
The data suggest that the COPD severity in middle-aged and older men with osteoporosis associates with decreased bone formation. COPD patients may exhibit bone metabolism dynamics characterized by low bone turnover with osteogenesis dysfunction as COPD becomes severe.

Keyword

Chronic obstructive pulmonary disease; Alkaline phosphatase; Procollagen type 1 N-Terminal propeptide; nal propeptide; Tartrate-resistant acid phosphatase 5b
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