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S48 OSTEOPOROSIS AND LOSS OF BONE MINERAL DENSITY IN CORTICOSTEROID-NAIVE MALE PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE
1JM Duckers, 1CE Bolton, 2BA Evans, 3W Evans, 4MD Stone, 1DJ Shale. 1Department of Respiratory Medicine, Cardiff University, Cardiff, UK, 2Department of Child Health, Cardiff University, Cardiff, UK, 3Department of Medical Physics, University Hospital of Wales, Cardiff, UK, 4Bone Research Unit, Cardiff University, Cardiff, UK
Background: Previously, we reported an increased prevalence of loss of bone mineral density (BMD) in patients with chronic obstructive pulmonary disease (COPD) with a third having undetected osteoporosis.1 Here, we hypothesised that loss of BMD occurs early in COPD progression and is independent of corticosteroid therapy.
Methods: Thirty corticosteroid-naive (inhaled or oral) male patients with COPD and 15 age-matched male controls were studied. Spirometry, incremental shuttle walking test (ISWT), BMD at hip and lumbar spine together with body composition (DXA, Hologic, Discovery) were performed.
Results: Previously undetected osteoporosis2 was present in 17% of patients (3% control) and osteopenia in 57% of patients (33% control). Results are presented in the table. In patients FFMI was related to BMD hip (r = 0.506, p = 0.004) but not BMD lumbar spine (r = 0.310, p>0.05). There was a trend that ISWT in patients was related to BMD hip (p = 0.06).
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Conclusions: Loss of BMD was evident in 74% of corticosteroid-naive male patients. The loss of BMD was more prominent at the hip compared with the lumbar spine. This difference may reflect loss of physical activity and subsequent deconditioning as suggested by the loss of fat-free mass and shorter ISWT distance in these patients. Bone thinning in COPD appears to occur early in the genesis of lung disease, to be independent of corticosteroid therapy and is associated with physical deconditioning, which should be targeted for intervention at initial diagnosis.
Acknowledgements: The authors wish to thank to Drs C Allanby, …