More than one-third of patients with COPD worldwide may have osteoporosis, according to a systematic review and meta-analysis published in CHEST.
“Osteoporosis-related fractures are associated with several adverse health outcomes in COPD including an increase in hospitalization and mortality rates, a decline in lung function, and poor quality of life. Consequently, interest in this area of research has increased over the past decade, resulting in the publication of numerous studies that investigated the prevalence and risk factors for osteoporosis in COPD,” the researchers wrote.
For this systematic review and meta-analysis, the researchers included 58 studies involving 8,753 patients with COPD. They found that the pooled global prevalence of osteoporosis was 38% (95% CI, 34-43) in patients with COPD. Notably, osteoporosis prevalence in patients with COPD did not differ across five world regions, including the Americas, eastern Mediterranean, Europe, Southeast Asia and the western Pacific (P = .49).
Additionally, results showed that the likelihood of having osteoporosis was nearly threefold higher in patients with vs. without COPD (adjusted pooled OR = 2.83; 95% CI, 2-4.03).
For patients with COPD, risk factors for low bone mineral density or osteoporosis included lower BMI and lower fat-free mass, with an analysis of two studies showing that BMI less than 18.5 kg/m2 was associated with a fourfold increase in the risk for osteoporosis (OR = 4.26; 95% CI, 1.07-16.99). Further, the meta-analysis of seven studies and two studies demonstrated a decreased risk for osteoporosis with a 1-kg/m2 increase in BMI (OR = 0.8; 95% CI, 0.76-0.85) and a 1-kg/m2 increase in fat-free mass (OR = 0.64; 95% CI, 0.49-0.83). The presence of sarcopenia was also associated with an increased likelihood of having osteoporosis in patients with COPD (OR = 3.65; 95% CI, 1.45-9.16).
“This systematic review and meta-analysis revealed that osteoporosis is a prevalent comorbidity worldwide in patients with COPD. Low body mass index and low muscle mass are associated with this increased prevalence. Individuals with COPD at high risk for osteoporosis should be identified early through screening, and strategies aimed at improving or controlling risk factors for osteoporosis should be implemented in the early stages of lung disease,” the researchers wrote. – by Melissa Foster
Disclosures: The authors report no relevant financial disclosures.