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What community measurements can be used to predict bone disease in patients with COPD?

Bolton, Charlotte Emma, Cannings-John, Rebecca Louise, Edwards, Peter H., Ionescu, Andreea Alina, Evans, William D., Pettit, Rebecca J., Faulkner, Trudy Ann, Stone, Michael D. and Shale, Dennis 2008. What community measurements can be used to predict bone disease in patients with COPD? Respiratory Medicine 102 (5) , pp. 651-657. 10.1016/j.rmed.2007.12.027

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Background: Osteoporosis is common in patients with COPD. Previously we have reported that loss of fat-free mass (FFM), measured by dual X-ray absorptiometry (DXA) is associated with loss of bone mineral density (BMD). In addition, in patients with a low body mass index (BMI) and a low FFM, all had evidence of bone thinning, 50% having osteopenia and 50% osteoporosis. We explored the utility of different anthropometric measures in detecting osteoporosis in a community-based COPD population. Methods: Patients with confirmed COPD and not on long-term oral corticosteroids (n ¼ 58) performed spirometry. They underwent nutritional assessment by skinfold anthropometry, midarm circumference, calculation of both % ideal body weight (IBW) and BMI. All had DXA assessment of BMD. Results: A total of 58 COPD patients had anthropometric measurements taken, with a mean age of 66.8 (SD 8.7) years, 31 (58%) were male, with a forced expiratory volume in 1 s (FEV1) of 54.17 (20.18)% predicted. Osteoporosis was present at either the hip or lumbar region in 14 patients (24%). The useful anthropometric measurements identifying those with osteoporosis were both % IBW and BMI. The adjusted odds ratio for %IBW was 0.93 (95% confidence interval (CI) 0.87, 0.99), p ¼ 0.016 and for BMI: 0.79 (0.64–0.98), p ¼ 0.03. The receiver operating characteristics (ROC) score for both was 0.88, indicating a good fit. Conclusion: Osteoporosis is common, even in patients with mild airways obstruction. Nutritional assessment, incorporating a calculation of their BMI or %IBW may confer an additional benefit in detecting those at risk of osteoporosis and guide referral for BMD measurement.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine
Uncontrolled Keywords: COPD; Osteoporosis; Body composition; Anthropometry
Publisher: Elsevier
ISSN: 0954-6111
Last Modified: 06 Sep 2022 08:12

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