Comparison of the Frequency of Osteoporosis and Osteopenia in Patients with Chronic Obstructive Pulmonary Disease with and Without Emphysema in Sari

Chronic obstructive pulmonary disease (COPD) is a progressive pulmonary ailment characterized by prolonged respiratory symptoms and airflow constriction. COPD stands as the third most prominent cause of mortality on a global scale. It is commonly linked to numerous extra-pulmonary conditions, such as cardiopulmonary disorders, musculoskeletal frailty, and anemia. Osteoporosis, regarded as one of the principal systemic complications arising from COPD, represents an elevated susceptibility to osteoporotic fractures and imposes a significant financial burden. Considering the clinical significance surrounding the emphysema phenotype in COPD, as well as the lack of investigation on this matter in the country, the objective of this study is to determine the comparative prevalence of osteoporosis and osteopenia in COPD patients, with and without emphysema, who receive medical attention at Tubi Sari Clinic and Imam Khomeini Hospital in Sari.

This cross-sectional study was conducted in 2021 on patients referred to the rheumatology and lung clinic, and COPD patients admitted to Imam Khomeini Hospital in Sari. In this study, 50 patients with COPD with emphysema as a case group and 50 patients with COPD without emphysema as a control group were included in the study. Then, using densitometry and examining the bone mass density of all COPD patients, the patients were divided into two groups: with and without osteoporosis. Then, the patient's information was entered into SPSS software and analyzed.

There was no significant difference in vitamin D serum levels, vertebral fracture score, or BMD between emphysema and non-emphysema patients (P=0.09, P=0.098). Multivariate analysis showed that (in a model including age, BMI, FEV1, PaO2, emphysema score, CRP, and dyspnea score) only BMI, FEV1, and PaO2 decreased as independent risk factors for low BMD.

Our findings showed that emphysema is an independent risk factor for osteoporosis according to the multivariate model. Low BMI, severity of COPD, and hypoxia play a dominant role in the development of osteoporosis.