Osteoporosis in Chronic Obstructive Pulmonary Disease: More than just a Comorbidity

  • Mradul Kumar Daga Director Professor, Department of Medicine, Maulana Azad Medical College, New Delhi, India. https://orcid.org/0000-0001-7774-7602
  • Naresh Kumar Professor of Medicine & Head, Pulmonary Medicine, Maulana Azad Medical College, New Delhi, India.
  • Raghu RV Post Graduate, Department of Medicine, Maulana Azad Medical College, New Delhi, India.
  • Govind Mawari Scientist - C, Centre for Occupational and Environmental Health, Maulana Azad Medical College, New Delhi, India.
  • Siddharth Chand Post Graduate, Department of Medicine, Maulana Azad Medical College, New Delhi, India.
  • J Aarthi Post Graduate, Department of Medicine, Maulana Azad Medical College, New Delhi, India.
  • Manish Kumar Jha Research Associate, Centre for Occupational and Environmental Health, Maulana Azad Medical College, New Delhi, India.
  • Maryam Hussain Department of Medicine, Maulana Azad Medical College, New Delhi, India.
Keywords: COPD, Osteoporosis, Bone Mineral Density (BMD), Vertebral Fracture, DEXA, FRAX

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is one of the leading causes of mortality and loss of Disability-Adjusted Life-Years (DALYs) worldwide. It often is accompanied by the presence of various systemic comorbidities including osteoporosis which may have an impact on the course of the disease. Osteopenia and osteoporosis are the consequences of loss of Bone Mineral Density (BMD) and have been widely known major comorbidities in COPD patients.

Female sex, age, and smoking are common pathogenic factors for both COPD and osteoporosis, other factors such as reduced daily physical activity, malnutrition, low body mass index, hypogonadism, vitamin D deficiency, chronic renal insufficiency, chronic hypoxemia, and drugs like corticosteroids, have been invoked to explain such a frequent association between them. Osteoporosis in COPD is however often undertreated. It has been shown in recent studies that both decreased Bone Mineral Density (BMD) and impaired bone quality contribute to bone fragility, causing fractures in COPD patients. Pulmonary function and activities of the daily life of COPD patients may be further deteriorated by osteoporosis-associated fractures. Calcium and vitamin D, hormone replacement when indicated, calcitonin, and bisphosphonate administration are few effective strategies to tackle bone loss and osteoporosis. Awareness about this high prevalence of osteoporosis in COPD patients is critically important and physicians should look for such fracture risks. Routine screening and early diagnosis of osteoporosis will enable physicians to provide the appropriate treatment to prevent fracture, which leads to improved quality of life as well as better long-term prognosis.

How to cite this article:
Daga MK, Kumar N, Raghu RV, Mawari G, Chand S, Aarthi J. Osteoporosis in Chronic Obstructive Pulmonary Disease: More than just a Comorbidity. J Adv Res Med 2020; 7(3): 7-12.

DOI: https://doi.org/10.24321/2349.7181.202011

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Published
2020-12-22

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