J Korean Med Sci.  2022 Feb;37(8):e66. 10.3346/jkms.2022.37.e66.

Relationships Between Pulmonary Function and Composite Indices of Femoral Neck Strength in Korean Men (KNHANES IV)

Abstract

Background
Despite the close relationship between osteoporosis and chronic pulmonary diseases, few studies have evaluated relationships between pulmonary functions and bone quality. We investigated associations between pulmonary function test results and femoral neck strength indices (SIs) in Korean men.
Methods
This population-based, cross-sectional study was conducted using data from the Korea National Health and Nutrition Examination Survey IV on 936 men aged ≥ 19 years. Pulmonary functions (forced vital capacity [FVC] and forced expiratory volume in one second [FEV1 ]) were measured using a dry rolling seal spirometer. Femoral neck SIs, relative to load, were calculated by hip dual-energy X-ray absorptiometry for compression strength index (CSI), bending strength index (BSI), and impact strength index (ISI).
Results
The 443 (47.3%) of the 936 men were current smokers. FVC, FVC percentage with respect to the expected normal value, FEV1 , and FEV1 percentage with respect to the expected normal value (FEV 1 p) were positively associated with CSI and BSI after adjusting for confounders, including smoking history (β = 0.003–0.223, P = 0.005–0.036). FEV1 and FEV1 p were positively associated with ISI (β = 0.000–0.014, P = 0.010–0.025). Of components of femoral neck SIs, bone mineral density was correlated with FEV1 and FEV1 p (β = 0.001–0.037, P = 0.017–0.019). After adjusting for all confounders, all femoral neck SIs increased with FVC quintiles (P for trends = 0.001–0.012), and CSI and BSI increased with FEV1 quintiles (Pfor trends = 0.034–0.043).
Conclusion
Reduced pulmonary function was correlated with reduced femoral neck strength, even after adjusting for smoking history in Korean men. Femoral neck SIs might be useful tools for evaluating bone health in men with reduced pulmonary function.

Keyword

Bone Quality; Composite Indices of Femoral Neck Strength; Osteoporosis; Pulmonary Function Test

Figure

  • Fig. 1 Femoral neck strengths by (A) FVC and (B) FEV1 quintiles. The multivariate model was adjusted for age, weight, height, 25-hydroxy vitamin D, calcium intake, phosphorus intake, physical activity, and drinking. Values are expressed as least-square means with 95% CI unless otherwise specified. P values for trends were generated by multiple linear regression analysis.FVC = forced vital capacity, FEV1 = forced expiratory volume in one second, CSI = compression strength index, BSI = bending strength index, ISI = impact strength index.a P < 0.05 vs. Q5 by post hoc analysis.


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