The quality of bone tissue and its mineral density in patients with chronic obstructive pulmonary disease

Abstract

Background. The objective of the work is to study the effect of chronic obstructive pulmonary disease (COPD) on mineral density (BMD) and trabecular bone score (TBS), depending on the degree of severity and women's age. Materials and methods. We have examined 30 women aged 57.43 ± 7.87 years, patients with COPD of various stages (GOLD 1–4). We have studied the BMD Total, BMD the lumbar spine (L1–L4), BMD Femur, and BMD Radius by means of dual-energy X-ray absorptiometry (DEXA). TBS of the lumbar spine (L1–L4) was determined by the TBS iNsight method (Med-Imaps, Pessac, France). Results. A significant decrease of the BMD was found at every skeletal area starting from GOLD 3, whereas at the L1–L4 level the BMD began to decrease at GOLD 2. The correlation was found between the severity of COPD and BMD Femur (r = –0.75, p < 0.05), BMD Radius (r = –0 73, p < 0.05), BMD L1–L4 (r = –0.80, p < 0.05) BMD Total (r = –0.73, p < 0.05). Starting from GOLD 2, the values of TBS significantly decreased and corresponded to the partial bone quality loss. The most pronounced changes occurred at the level of TBS L1 and corresponded to a significant bone quality loss already at GOLD 2. The TBS progressively decreased and at GOLD 3–4 corresponded to a significant loss of bone quality. The correlation was found between the severity of COPD and TBS of the spine at the level of L1–L4 (r = –0.76, p<0.05), TBS of the spine at the level of L2–L4 (r = –0.75, p<0.05). Conclusions. Age equally affects both BMD and TBS in women with COPD, and from the age of 45, these rates progressively decrease. The effect of COPD on bone tissue according to the severity of the disease is heterogeneous at different segments of the axial skeleton. The earliest changes concern the decrease in BMD L1-L4 (1.19 ± 0.05) g/cm2 compared to GOLD 1 (1.39 ± 0.05) g/cm2 (p < 0.05) and TBS L1 (1.17 ± 0.06) in comparison with GOLD 1 (1.34 ± 0.06; p < 0.05), whose decrease is observed already at GOLD 2.