Chest
ReviewsCOPD and Osteoporosis
Section snippets
Low Bone Mineral Density
Osteoporosis is characterized by low bone mass accompanied by microarchitectural changes in bone that increase the susceptibility to fracture.910 The World Health Organization definition for osteoporosis is based on the measurement of bone mineral density (BMD).11 Osteopenia is defined as a BMD between 1 and 2.5 SDs below the mean for young adults (ie, the T score), while osteoporosis is defined as a BMD of > 2.5 SDs below the mean for young adults.11 This definition was developed for white
Pathophysiology of Osteoporosis in COPD
There are numerous risk factors that contribute to the pathophysiology of osteoporosis seen in COPD patients. These risk factors include smoking, vitamin D deficiency, low body mass index (BMI), hypogonadism, and decreased mobility as the disease progresses (Table 2). In addition to these risk factors, glucocorticoid use in many patients with COPD is thought to be a contributing factor in the development of osteoporosis. However, since osteoporosis has been reported in COPD patients who have no
Prevention and Treatment
The prevention of osteoporosis in COPD patients is dependent on an awareness of the magnitude of the problem. There is little impetus for screening and/or preventive therapy because patients are generally asymptomatic until they experience a fracture. However, early recognition and the institution of preventive therapy are essential in avoiding fractures. Patients who are being started on long-term inhaled or oral glucocorticoid therapy should be considered for preventive therapy since
Recommendations and Summary
Preventive strategies to decrease osteoporotic fractures in those patients with COPD should begin with screening for the disease. All patients receiving long-term oral glucocorticoid therapy (> 7.5 mg prednisone/d) should have BMD testing. Ideally, BMD should be measured prior to initiating therapy, especially in those patients at highest risk such as postmenopausal women. BMD measurement also should be considered in COPD patients at high risk for osteoporosis such as those receiving high-dose
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2020, Respiratory MedicineSmoking as a risk factor for spontaneous bone anchored hearing implant extrusion: A case report and review of literature
2020, Otolaryngology Case ReportsCitation Excerpt :Peri-implant bone quality, bone density, diabetes, age, radiation exposure, and osteoporosis are amongst the known risk factors that may jeopardize the stability outcome of osseointegrated implants [7,9–14]. Studies have identified smoking as a risk factor for osteoporosis, bone loss and bone fracture [3,15–17]. Clinical reports show higher revision rates of orthopedic hip and knee replacements as well as dental implant placement in smokers compared to nonsmokers [2,18–20].