TY - JOUR
T1 - CT-measured bone attenuation in patients with chronic obstructive pulmonary disease: Relation to clinical features and outcomes
AU - Romme, E.A.P.M.
AU - Murchison, J.T.
AU - Edwards, L.D.
AU - van Beek, E.J.R
AU - Murchison, D.M.
AU - Rutten, E.P.
AU - Smeenk, F.W.
AU - Williams, M.C.
AU - Wouters, E.F.M.
AU - MacNee, W.
PY - 2013/6
Y1 - 2013/6
N2 - Osteoporosis is highly prevalent in COPD patients and has been related to several clinical features. However, most studies have been in relatively small COPD cohorts. Therefore, the objectives of this study were to compare bone attenuation measured on low-dose chest computed tomography (CT) between COPD subjects, smoker and non-smoker controls, and to relate bone attenuation to clinical parameters, inflammatory biomarkers and outcomes in a large, well-characterized COPD cohort. We studied 1634 COPD subjects, 259 smoker controls and 186 non-smoker controls who participated in a large longitudinal study (ECLIPSE). We measured bone attenuation, extent of emphysema and coronary artery calcification (Agatston score) on baseline CT scans, and clinical parameters, inflammatory biomarkers and outcomes. Bone attenuation was lower in COPD subjects compared with smoker and non-smoker controls (164.9+/-49.5 HU versus 183.8+/-46.1 HU versus 212.1+/-54.4 HU, p<0.001). Bone attenuation was not significantly different between COPD subjects and smoker controls after adjustment for age, sex and pack-years of smoking(=). In the COPD subjects, bone attenuation correlated positively with FEV(1) (r=0.062, p=0.014), FEV(1) /FVC ratio (r=0.102, p<0.001), body mass index (r=0.243, p<0.001), fat free mass index (FFMI, r=0.265, p<0.001) and C-reactive protein (r=0.104, p<0.001), and correlated negatively with extent of emphysema (r=-0.090, p<0.001), Agatston score (r=-0.177, p<0.001) and interleukin-8 (r=-0.054, p=0.035). In a multiple regression model, older age, lower FFMI and higher Agatston score were associated with lower bone attenuation. Lower bone attenuation was associated with higher exacerbation (r=-0.057, p=0.022) and hospitalization (r=-0.078, p=0.002) rates, but was not associated with all-cause mortality. In conclusion, CT measured bone attenuation was lower in COPD subjects compared with non-smoker controls but not compared with smoker controls, after adjustment for age, sex and pack-years of smoking. In the COPD subjects, bone attenuation was associated with age, body composition and coronary artery calcification, but was not associated with all-cause mortality. (c) 2013 American Society for Bone and Mineral Research.
AB - Osteoporosis is highly prevalent in COPD patients and has been related to several clinical features. However, most studies have been in relatively small COPD cohorts. Therefore, the objectives of this study were to compare bone attenuation measured on low-dose chest computed tomography (CT) between COPD subjects, smoker and non-smoker controls, and to relate bone attenuation to clinical parameters, inflammatory biomarkers and outcomes in a large, well-characterized COPD cohort. We studied 1634 COPD subjects, 259 smoker controls and 186 non-smoker controls who participated in a large longitudinal study (ECLIPSE). We measured bone attenuation, extent of emphysema and coronary artery calcification (Agatston score) on baseline CT scans, and clinical parameters, inflammatory biomarkers and outcomes. Bone attenuation was lower in COPD subjects compared with smoker and non-smoker controls (164.9+/-49.5 HU versus 183.8+/-46.1 HU versus 212.1+/-54.4 HU, p<0.001). Bone attenuation was not significantly different between COPD subjects and smoker controls after adjustment for age, sex and pack-years of smoking(=). In the COPD subjects, bone attenuation correlated positively with FEV(1) (r=0.062, p=0.014), FEV(1) /FVC ratio (r=0.102, p<0.001), body mass index (r=0.243, p<0.001), fat free mass index (FFMI, r=0.265, p<0.001) and C-reactive protein (r=0.104, p<0.001), and correlated negatively with extent of emphysema (r=-0.090, p<0.001), Agatston score (r=-0.177, p<0.001) and interleukin-8 (r=-0.054, p=0.035). In a multiple regression model, older age, lower FFMI and higher Agatston score were associated with lower bone attenuation. Lower bone attenuation was associated with higher exacerbation (r=-0.057, p=0.022) and hospitalization (r=-0.078, p=0.002) rates, but was not associated with all-cause mortality. In conclusion, CT measured bone attenuation was lower in COPD subjects compared with non-smoker controls but not compared with smoker controls, after adjustment for age, sex and pack-years of smoking. In the COPD subjects, bone attenuation was associated with age, body composition and coronary artery calcification, but was not associated with all-cause mortality. (c) 2013 American Society for Bone and Mineral Research.
KW - COPD
KW - OSTEOPOROSIS
KW - BONE DENSITY
KW - COMPUTED TOMOGRAPHY
KW - CORONARY ARTERY CALCIFICATION
KW - CORONARY-ARTERY CALCIUM
KW - MINERAL DENSITY
KW - SYSTEMIC INFLAMMATION
KW - EMPHYSEMA
KW - MEN
KW - COMORBIDITIES
KW - WOMEN
KW - FRACTURES
U2 - 10.1002/jbmr.1873
DO - 10.1002/jbmr.1873
M3 - Article
SN - 0884-0431
VL - 28
SP - 1369
EP - 1377
JO - Journal of Bone and Mineral Research
JF - Journal of Bone and Mineral Research
IS - 6
ER -