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Original Research |

Clinical implications of sarcopenia on decreased bone density in men with chronic obstructive pulmonary disease

Ji An Hwang; Young Sam Kim; Ah Young Leem; Moo Suk Park; Se Kyu Kim; Joon Chang; Ji Ye Jung
Author and Funding Information

DISCLOSURE

The authors have no conflicts of interest.

1Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

2Division of Pulmonology, Department of Internal Medicine, Institute of Chest Diseases, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

Corresponding Author: Ji Ye Jung, MD, Division of Pulmonology, Department of Internal Medicine, Institute of Chest Diseases Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.


Copyright 2016, . All Rights Reserved.


Chest. 2016. doi:10.1016/j.chest.2016.12.006
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Abstract

Background  Sarcopenia and osteoporosis are systemic features of chronic obstructive pulmonary disease (COPD). The present study investigated the association between sarcopenia and osteopenia/osteoporosis, and the factors associated with low bone mineral density (BMD) in men with COPD.

Methods  Data of 777 men with COPD who underwent both pulmonary function test and dual energy X-ray absorptiometry were extracted from the Korean National Health and Nutritional Examination Survey database between 2008 and 2011. Sarcopenia was assessed with the appendicular skeletal mass index (ASMI) and osteopenia/osteoporosis with the T-score.

Results  As the severity of airflow limitation increased, sarcopenia prevalence increased (Ptrend<0.001). Additionally, as the degree of sarcopenia became severe, osteopenia/osteoporosis prevalence increased (Ptrend<0.001), and a significant positive correlation was noted between appendicular skeletal muscle mass and BMD (ASMI–T-score: r=0.408, P<0.001). Sarcopenia was independently associated with an increased risk of low BMD in men with COPD (OR=2.31; 95%CI,1.53–3.46; P<0.001). Old age and low fat mass were significantly associated with low BMD in both sarcopenic and non-sarcopenic participants. High serum hemoglobin and insulin levels were associated with a reduced risk of low BMD only in the sarcopenic participants, while exercise and dietary intake were associated with a reduced risk only in the non-sarcopenic participants.

Conclusions  Sarcopenia is closely correlated with osteopenia/osteoporosis in men with COPD. Moreover, different factors are associated with low BMD according to the presence/absence of sarcopenia in that population.


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