EVALUATION OF BONE DEMINERALIZATION IN COPD PHENOTYPES

Objective: Diminished bone mineral density in patients with chronic obstructive pulmonary disease have increased risk for osteoporosis and its associated fractures. Even though the relationship between different phenotypes of chronic obstructive pulmonary disease and bone mineral density was not fully understood. The aim of this study was to evaluate bone mineral density in different phenotypes of chronic obstructive pulmonary disease and compare these outcomes with an age-correlated control group. Methods: In this retrospective study 100 patients (emphysematous, chronic bronchitis and healthy control group) were participated. Participants underwent DXA absorptiometry to evaluate bone mineral density. Spirometric pulmonary function tests, 6-minute walk test, bode index, and modified medical research council dyspnea score, body mass index and levels of calcium, vitamin D and parathormone were also evaluated. Comparative assessment of the findings was performed and statistical analysis was applied in present study. Results: Patients with the emphysematous phenotype had significantly lower femur bone mineral density (P = 0.05), body mass index (P < 0.05), than chronic bronchitis phenotype. Inverse correlations were revealed between lumbar bone mineral density and modified medical research council dyspnea score. Statistical analysis was performed by the multivariate logistic regression analysis model test and Tukey tests (p < 0.05). On ANOVA analysis, the emphysematous group have two fold higher risk of osteoporosis and lower bone mineral density detected than other groups(OR 1.947, 95% CI (1.009-3.792), P = 0.081; OR, 1.863,95% CI (1.027-3.274), P = 0.037). Conclusion: The evaluation of bone loss rate among groups, emphysematous phenotype had more risk in developing osteoporosis, low bone mineral density and a little less osteopenia than other groups.