Smokers with emphysema and small airway disease on computed tomography have lower bone density

Abstract

Osteoporosis is more common in patients with COPD and in smokers. The aim of this study was to assess whether measures of emphysema and airway disease on computed tomography (CT) were associated with lower bone density or vertebral fractures in smokers with and without COPD. For this purpose, we included participants from the NELSON lung cancer screening trial. Bone density was measured as Hounsfield Units in the first lumbar vertebra, and vertebral fractures were assessed semiquantitatively. The 15th percentile method (Perc15) was used to assess emphysema, and the airway lumen perimeter (Pi10) was used for airway wall thickness. Expiratory/inspiratory-ratio _{mean lung density} (E/I-ratio _MLD) was used as a measure for air trapping and tracheal index to assess tracheal deformity. Linear regression models and logistic regression models were used to assess associations between CT biomarkers, bone density, and presence of fractures. Exactly 1,093 male participants were eligible for analysis. Lower Perc15 and higher E/I-ratio _MLD were significantly associated with lower bone density ( b=−1.27, P=0.02 and b=−0.37, P=0.02, respectively). Pi10 and tracheal index were not associated with bone density changes. CT-derived biomarkers were not associated with fracture prevalence. Bone density is lower with increasing extent of emphysema and small airway disease but is not associated with large airway disease and tracheal deformity. This may indicate the necessity to measure bone density early in smokers with emphysema and air trapping to prevent vertebral fractures.

Journal

Journal ID (nlm-ta): Int J Chron Obstruct Pulmon Dis

Journal ID (iso-abbrev): Int J Chron Obstruct Pulmon Dis

Journal ID (publisher-id): International Journal of COPD

Title: International Journal of Chronic Obstructive Pulmonary Disease

Publisher: Dove Medical Press

ISSN (Print): 1176-9106

ISSN (Electronic): 1178-2005

Publication date Collection: 2016

Publication date (Electronic): 08 June 2016

Volume: 11

Pages: 1207-1216

Affiliations

[1 ]Department of Pulmonology, University Medical Center Utrecht, Utrecht, the Netherlands

[2 ]Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands

[3 ]Department of Radiology, Radboud University Medical Center, Nijmegen, the Netherlands

[4 ]Center for Medical Imaging-North East Netherlands, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands

[5 ]Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands

[6 ]Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands

Author notes

Correspondence: Esther Pompe, Department of Pulmonology, University Medical Center Utrecht, Postbus 85500, 3508 GA Utrecht, Postbox: E.03.511, the Netherlands, Tel [phone], Email e.pompe@ 123456umcutrecht.nl

Article

Publisher ID: copd-11-1207

DOI: 10.2147/COPD.S103680

PMC ID: 4907479

PubMed ID: 27354779

Copyright statement: © 2016 Pompe et al. This work is published and licensed by Dove Medical Press Limited

License:

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Categories

Subject: Original Research