Prevalence of Osteoporosis and Osteopenia in
Thai COPD Patients
Nuttapol Rittayamai MD*,
Benjamas Chuaychoo MD*, Apiradee Sriwijitkamol MD**
Affiliation :
* Division of Respiratory Diseases and Tuberculosis, Faculty of Medicine Siriraj Hospital,
Mahidol University, Bangkok, Thailand
** Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Siriraj Hospital,
Mahidol University, Bangkok, Thailand
Objective : To study the prevalence of osteoporosis and osteopenia in Thai COPD patients and the factors associated with
osteoporosis.
Material and Method: A cross sectional study was used to evaluate 102 male stable COPD patients. Bone mineral density
at lumbar spine (L2-4) and femoral neck were measured by dual energy x-ray absorptiometer scan. Demographic data
including age, body mass index (BMI), inhaled corticosteroids use, tobacco smoke, force expiratory volume at 1 second
(FEV1), and high sensitivity C-reactive protein (hs-CRP) were analyzed.
Results : The overall prevalence of osteoporosis and osteopenia according to the lowest T-score at either L2-4 or femoral
neck were 31.4% and 32.4%, respectively. This prevalence of osteoporosis in COPD patients was higher than that in age-
matched Thai males from historical data (31.4% vs. 12.6%, respectively). BMI and hs-CRP were significantly associated
with osteoporosis. There was no association between osteoporosis and severity of COPD, age, smoking, and corticosteroid
use. The predictive value of BMI < 20.5 kg/m2 and hs-CRP > 2.3 mg/L demonstrated risk of osteoporosis in COPD patients
(adjusted Odds ratio 7.2 and 4.1, respectively).
Conclusion : The prevalence of osteoporosis and osteopenia in Thai COPD patients was higher than that in normal age-
matched Thai males. Osteoporosis was associated with low BMI and high level of hs-CRP when compared to COPD patients
with normal bone mineral density.
Keywords : Bone mineral density, Chronic obstructive pulmonary disease, Osteoporosis, Prevalence, Systemic inflammation
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