Functional condition of bone tissue in smoking and non-smoking patients with chronic obstructive pulmonary disease

Aim. To evaluate bone and calcium-phosphorus metabolism, bone tissue density (BTD) in smokers and non-smokers with chronic obstructive pulmonary disease (COPD). Material and methods. The study included 120 patients with COPD; smokers (n = 68), smokers in the past (n = 8) and non-smokers (n = 44). Control 80 healthy subjects were matched by age and sex. Bone metabolism was estimated by concentration of osteocalcin (OC), markers of bone resorption (TRAP, beta CrossLqps-beta CL). Results. Smoking aggravates disturbance of calcium metabolism in COPD leading to hypocalcaemia and hypercalciuria. In smokers with COPD bone remodeling dysfunction is caused by suppression of osteogenesis and enhancement of resorption, in non-smokers - intensification of both resorption and osteogenesis. The analysis of correlations has shown that there is a close correlation between the level of TRAP, bone mineral density scores and indices of pack-years (r = -075, p < 0. 01; r = -0. 6, p < 0. 01, respectively). Anamnesis of smoking has a positive correlation with TRAP (r = 0. 85, p < 0. 001) and a negative correlation with bone density (r = -0. 8, p < 0. 01) and OC (r = -0. 55, p < 0. 01). Conclusion. Duration of smoking (total pack-years) is an additional marker of osteopenic syndrome in COPD. This is confirmed by close correlation of this parameter with bone density and markers of bone resorption.