Comparison of the Osteoporosis between Male Smokers with and without Chronic Obstructive Pulmonary Disease


1 Department of Pulmonary Medicine

2 Department of Rheumatology, Hazrate Rasool-e-Akram Hospital, Iran University of Medical Sciences and Health Services

3 Community Medicine unit, Qom University of Medical Sciences and Health Services, TERHAN-IRAN


Background: Osteoporosis is the most common metabolic bone disease that represents an increasingly serious problem, particularly as the population ages. It occurs because loss of bone mineral content. Osteoporosis, thus, causes significant morbidity, especially in elderly, due to recurrent pathologic fractures. It has been suggested that Chronic Obstructive Pulmonary Disease (COPD) is a risk factor for osteoporosis. We intended to investigate the relationship between COPD and osteoporosis in our patient population. Materials and Methods: Setting: Pulmonary diseases division of Hazrate Rasool-e-Akram hospital. Design: It is a case- control study. Target: One hundred volunteer men with history of at least 20 pack year cigarette smoking were sequentially assigned into two groups: 50 patients with COPD (according to the result of spirometry) and a control group of 50 individuals of matching age. Interventions: All individuals were underwent Bone Mass Densitometry (BMD) by Dual-Energy X-Ray Absorptiometry (DEXA), and Pulmonary Function Testing (PFT). Statistical Analysis: The data was processed using descriptive statistical analysis and t-test and χ 2 test. Results: The frequency of osteoporosis in our patient and control groups were 52% (26 patients) and 8% (4 persons), respectively. The mean T-score value of spinal bone density in patient and control groups were -1.15 and +0.62 respectively (p <0.0001). The mean T-score value of femoral bone density was -2.58 in patient group and -0.49 in controls (p <0.0001). There was a statistically significant correlation between the presence of osteoporosis with both the severity and duration of COPD (p <0.0001). However, BMD was not correlated with the body mass index (BMI), age or the amount of cigarette smoking. Patients with COPD are 12.5 times more likely than their controls to develop osteoporosis (OR: 12.46, CI 95% = 3.9 – 39.85). Conclusion: Our study confirms that COPD is a risk factor for osteoporosis. There may be many contributing factors such as immobility, chronic respiratory acidosis and the use of gluccocorticoids. Therefore, prevention of osteoporosis should be a part of medical care for COPD patients. (Tanaffos 2004; 3(9): 13-18)