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Independent association of bone mineral density and trabecular bone score to vertebral fracture in male subjects with chronic obstructive pulmonary disease.
Osteoporos Int. 2018 03; 29(3):615-623.OI

Abstract

Osteoporosis is a major comorbidity of chronic obstructive pulmonary disease (COPD), but the mechanism of bone fragility is unknown. We demonstrated that trabecular bone score, a parameter of bone quality, was associated with systemic inflammation and was a significant determinant of vertebral fracture independent of bone mineral density.

INTRODUCTION

COPD is a major cause of secondary osteoporosis. However, the mechanism of bone fragility is unclear. We previously reported that vertebral fracture was highly prevalent in male COPD patients. To obtain clues to the mechanism of COPD-associated osteoporosis, we attempted to identify determinants of prevalent vertebral fracture in this study.

METHODS

In this cross-sectional study, we recruited 61 COPD males and examined pulmonary function, vertebral fractures, bone mineral density (BMD), trabecular bone score (TBS), bone turnover markers, and inflammatory parameters. Determinants of the bone parameters were examined by multivariable analyses.

RESULTS

The prevalence of any and grade 2 or 3 fractures was 75.4 and 19.7%, respectively. Osteoporosis and osteopenia defined by BMD were present in 37.7 and 39.3%, respectively. TBS was significantly lower in higher Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages compared to GOLD 1. Multivariable logistic regression analysis revealed that both TBS and BMD were independent determinants of grade 2 or 3 vertebral fractures (OR = 0.271, 95%CI 0.083-0.888, p = 0.031; OR = 0.242, 95%CI 0.075-0.775, p = 0.017) after adjustment for age. Correlates of TBS included age, BMD, high-sensitivity C-reactive protein (hsCRP), pulmonary function parameters, parathyroid hormone, and Tracp-5b. In multivariable regression analysis, hsCRP was the only independent determinant of TBS besides age and BMD. In contrast, independent determinants of BMD included body mass index and, to a lesser extent, 25-hydroxyvitamin D.

CONCLUSION

Both BMD and TBS were independently associated with grade 2 or 3 vertebral fracture in COPD male subjects, involving distinct mechanisms. Systemic inflammation, as reflected by increased hsCRP levels, may be involved in deterioration of the trabecular microarchitecture in COPD-associated osteoporosis, whereas BMD decline is most strongly associated with weight loss.

Authors+Show Affiliations

Division of Endocrinology and Metabolism, Third Department of Medicine, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara-shi, Chiba, 299-0111, Japan.Division of Endocrinology and Metabolism, Third Department of Medicine, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara-shi, Chiba, 299-0111, Japan.Division of Endocrinology and Metabolism, Third Department of Medicine, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara-shi, Chiba, 299-0111, Japan.Division of Endocrinology and Metabolism, Third Department of Medicine, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara-shi, Chiba, 299-0111, Japan.Division of Endocrinology and Metabolism, Third Department of Medicine, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara-shi, Chiba, 299-0111, Japan. inoued@med.teikyo-u.ac.jp.Division of Endocrinology and Metabolism, Third Department of Medicine, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara-shi, Chiba, 299-0111, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29167970

Citation

Watanabe, R, et al. "Independent Association of Bone Mineral Density and Trabecular Bone Score to Vertebral Fracture in Male Subjects With Chronic Obstructive Pulmonary Disease." Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, vol. 29, no. 3, 2018, pp. 615-623.
Watanabe R, Tai N, Hirano J, et al. Independent association of bone mineral density and trabecular bone score to vertebral fracture in male subjects with chronic obstructive pulmonary disease. Osteoporos Int. 2018;29(3):615-623.
Watanabe, R., Tai, N., Hirano, J., Ban, Y., Inoue, D., & Okazaki, R. (2018). Independent association of bone mineral density and trabecular bone score to vertebral fracture in male subjects with chronic obstructive pulmonary disease. Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 29(3), 615-623. https://doi.org/10.1007/s00198-017-4314-7
Watanabe R, et al. Independent Association of Bone Mineral Density and Trabecular Bone Score to Vertebral Fracture in Male Subjects With Chronic Obstructive Pulmonary Disease. Osteoporos Int. 2018;29(3):615-623. PubMed PMID: 29167970.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Independent association of bone mineral density and trabecular bone score to vertebral fracture in male subjects with chronic obstructive pulmonary disease. AU - Watanabe,R, AU - Tai,N, AU - Hirano,J, AU - Ban,Y, AU - Inoue,D, AU - Okazaki,R, Y1 - 2017/11/22/ PY - 2017/07/12/received PY - 2017/11/13/accepted PY - 2017/11/24/pubmed PY - 2019/2/26/medline PY - 2017/11/24/entrez KW - Bone quality KW - C-reactive protein (CRP) KW - Chronic obstructive pulmonary disease (COPD) KW - Osteoporosis KW - Trabecular bone score (TBS) SP - 615 EP - 623 JF - Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA JO - Osteoporos Int VL - 29 IS - 3 N2 - : Osteoporosis is a major comorbidity of chronic obstructive pulmonary disease (COPD), but the mechanism of bone fragility is unknown. We demonstrated that trabecular bone score, a parameter of bone quality, was associated with systemic inflammation and was a significant determinant of vertebral fracture independent of bone mineral density. INTRODUCTION: COPD is a major cause of secondary osteoporosis. However, the mechanism of bone fragility is unclear. We previously reported that vertebral fracture was highly prevalent in male COPD patients. To obtain clues to the mechanism of COPD-associated osteoporosis, we attempted to identify determinants of prevalent vertebral fracture in this study. METHODS: In this cross-sectional study, we recruited 61 COPD males and examined pulmonary function, vertebral fractures, bone mineral density (BMD), trabecular bone score (TBS), bone turnover markers, and inflammatory parameters. Determinants of the bone parameters were examined by multivariable analyses. RESULTS: The prevalence of any and grade 2 or 3 fractures was 75.4 and 19.7%, respectively. Osteoporosis and osteopenia defined by BMD were present in 37.7 and 39.3%, respectively. TBS was significantly lower in higher Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages compared to GOLD 1. Multivariable logistic regression analysis revealed that both TBS and BMD were independent determinants of grade 2 or 3 vertebral fractures (OR = 0.271, 95%CI 0.083-0.888, p = 0.031; OR = 0.242, 95%CI 0.075-0.775, p = 0.017) after adjustment for age. Correlates of TBS included age, BMD, high-sensitivity C-reactive protein (hsCRP), pulmonary function parameters, parathyroid hormone, and Tracp-5b. In multivariable regression analysis, hsCRP was the only independent determinant of TBS besides age and BMD. In contrast, independent determinants of BMD included body mass index and, to a lesser extent, 25-hydroxyvitamin D. CONCLUSION: Both BMD and TBS were independently associated with grade 2 or 3 vertebral fracture in COPD male subjects, involving distinct mechanisms. Systemic inflammation, as reflected by increased hsCRP levels, may be involved in deterioration of the trabecular microarchitecture in COPD-associated osteoporosis, whereas BMD decline is most strongly associated with weight loss. SN - 1433-2965 UR - https://www.unboundmedicine.com/medline/citation/29167970/Independent_association_of_bone_mineral_density_and_trabecular_bone_score_to_vertebral_fracture_in_male_subjects_with_chronic_obstructive_pulmonary_disease_ L2 - https://doi.org/10.1007/s00198-017-4314-7 DB - PRIME DP - Unbound Medicine ER -