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Chronic obstructive pulmonary disease severity in middle-aged and older men with osteoporosis associates with decreased bone formation

Osteoporosis and Sarcopenia 2020년 6권 4호 p.179 ~ 184
Tsukamoto Manabu, Mori Toshiharu, Nakamura Eiichiro, Okada Yasuaki, Fukuda Hokuto, Yamanaka Yoshiaki, Sabanai Ken, Wang Ke-Yong, Hanagiri Takeshi, Kuboi Satoshi, Yatera Kazuhiro, Sakai Akinori,
소속 상세정보
 ( Tsukamoto Manabu ) - University of Occupational and Environmental Health School of Medicine Department of Orthopaedic Surgery
 ( Mori Toshiharu ) - Shin-Kokura Hospital Department of Orthopedic Surgery
 ( Nakamura Eiichiro ) - University of Occupational and Environmental Health School of Medicine Department of Orthopaedic Surgery
 ( Okada Yasuaki ) - University of Occupational and Environmental Health School of Medicine Department of Orthopaedic Surgery
 ( Fukuda Hokuto ) - University of Occupational and Environmental Health School of Medicine Department of Orthopaedic Surgery
 ( Yamanaka Yoshiaki ) - University of Occupational and Environmental Health School of Medicine Department of Orthopaedic Surgery
 ( Sabanai Ken ) - University of Occupational and Environmental Health School of Medicine Department of Orthopaedic Surgery
 ( Wang Ke-Yong ) - University of Occupational and Environmental Health School of Medicine Shared-Use Research Center
 ( Hanagiri Takeshi ) - Shin-Kokura Hospital Department of Thoracic Surgery
 ( Kuboi Satoshi ) - Shin-Kokura Hospital Department of Respiratory Medicine
 ( Yatera Kazuhiro ) - University of Occupational and Environmental Health School of Medicine Department of Respiratory Medicine
 ( Sakai Akinori ) - University of Occupational and Environmental Health School of Medicine Department of Orthopaedic Surgery

Abstract


Objectives: Chronic obstructive pulmonary disease (COPD) is a risk factor for osteoporosis. Nevertheless, much remains unclear regarding the bone metabolism dynamics associated with COPD. The present study focuses on the associations between the COPD severity and serum bone metabolism biomarkers.

Methods: We enrolled 40 patients who visited the orthopedics departments at our institutions and underwent dual-energy X-ray absorptiometry between September 2015 and December 2017. Only male osteoporosis patients over 45 years of age were included, and 5 patients were excluded due to disease or use of internal medicines affecting bone metabolism. All subjects underwent lung function testing, spine radiography, and blood tests. We measured percent forced expiratory volume in 1 second (%FEV1), which reflects COPD severity, and we examined the relationships between %FEV1 and serum levels of bone metabolism biomarkers.

Results: All subjects were diagnosed with osteoporosis based on T-scores. %FEV1 correlated with body weight, body mass index (BMI), and Z-score/T-scores. %FEV1 moderately correlated with serum levels of alkaline phosphatase (ALP), procollagen type 1 N-terminal propeptide (P1NP), and tartrate-resistant acid phosphatase 5b in the partial correlation analysis adjusted for BMI or T-score in the lumbar vertebrae. We performed a hierarchical multiple regression analysis to identify that serum ALP and P1NP were the independent explanatory variables to %FEV1 independent of other factors.

Conclusions: The data suggest that the COPD severity in middle-aged and older men with osteoporosis associates with decreased bone formation. COPD patients may exhibit bone metabolism dynamics characterized by low bone turnover with osteogenesis dysfunction as COPD becomes severe.

키워드

Chronic obstructive pulmonary disease; Alkaline phosphatase; Procollagen type 1 N-Terminal propeptide; Male osteoporosis; Tartrate-resistant acid phosphatase 5b

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