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Original Research: COPD |

Relationship Between Pulmonary Emphysema and Osteoporosis Assessed by CT in Patients With COPD

Tadashi Ohara, MD; Toyohiro Hirai, MD, PhD; Shigeo Muro, MD, PhD; Akane Haruna, MD; Kunihiko Terada, MD; Daisuke Kinose, MD; Satoshi Marumo, MD; Emiko Ogawa, MD, PhD; Yuma Hoshino, MD, PhD; Akio Niimi, MD, PhD; Kazuo Chin, MD, PhD; Michiaki Mishima, MD, PhD
Author and Funding Information

*From the Department of Respiratory Medicine (Drs. Ohara, Hirai, Muro, Haruna, Terada, Kinose, Marumo, Ogawa, Niimi, and Mishima), Graduate School of Medicine, and the Departments of Experimental Therapeutics (Dr. Hoshino) and Physical Therapeutics (Dr. Chin), Kyoto University, Kyoto, Japan.

Correspondence to: Toyohiro Hirai, MD, PhD, Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kawahara 54, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan; e-mail: t_hirai@kuhp.kyoto-u.ac.jp


This study was partly supported by a grant to the Respiratory Failure Research Group from the Ministry of Health, Labour, and Welfare, Japan.

The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Chest. 2008;134(6):1244-1249. doi:10.1378/chest.07-3054
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Background:  Osteoporosis is one of the important systemic features of COPD. Although COPD itself is regarded as one risk factor for osteoporosis, the relationship between the extent of emphysema and reduced bone density is still unclear. Our first aim was therefore to measure vertebral bone density and the percentage of low-attenuation area (LAA%) in the lungs using chest CT scans in COPD patients. Our second aim was to investigate the relationships among CT scan measurements, anthropometric parameters, and pulmonary function.

Methods:  Chest CT scans and pulmonary function tests were performed in 65 male patients with COPD. Using CT images, the CT scan density of the thoracic and lumbar vertebrae (T4, T7, T10, and L1) and the LAA% were measured quantitatively, and their correlations were analyzed.

Results:  Linear regression analyses revealed that LAA% had a significant negative correlation with bone mineral density (BMD) [r = −0.522]. In addition, multiple regression analysis showed that only LAA% and body mass index (BMI) were predictive of BMD among age, BMI, smoking index, FEV1, arterial blood gas, and LAA%.

Conclusions:  The extent of pulmonary emphysema significantly correlated with reduced bone density. Our study suggested that COPD itself could be a risk factor for osteoporosis and that chest CT scanning is useful for the management of COPD as a systemic disease.

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