CT-measured bone attenuation in patients with chronic obstructive pulmonary disease: Relation to clinical features and outcomes

E.A.P.M. Romme, J.T. Murchison, L.D. Edwards, E.J.R van Beek, D.M. Murchison, E.P. Rutten, F.W. Smeenk, M.C. Williams, E.F.M. Wouters, W. MacNee

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Abstract

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.
Original languageEnglish
Pages (from-to)1369-1377
Number of pages9
JournalJournal of Bone and Mineral Research
Volume28
Issue number6
DOIs
Publication statusPublished - Jun 2013

Keywords

  • COPD
  • OSTEOPOROSIS
  • BONE DENSITY
  • COMPUTED TOMOGRAPHY
  • CORONARY ARTERY CALCIFICATION
  • CORONARY-ARTERY CALCIUM
  • MINERAL DENSITY
  • SYSTEMIC INFLAMMATION
  • EMPHYSEMA
  • MEN
  • COMORBIDITIES
  • WOMEN
  • FRACTURES

Cite this

Romme, E. A. P. M., Murchison, J. T., Edwards, L. D., van Beek, E. J. R., Murchison, D. M., Rutten, E. P., ... MacNee, W. (2013). CT-measured bone attenuation in patients with chronic obstructive pulmonary disease: Relation to clinical features and outcomes. Journal of Bone and Mineral Research, 28(6), 1369-1377. https://doi.org/10.1002/jbmr.1873
Romme, E.A.P.M. ; Murchison, J.T. ; Edwards, L.D. ; van Beek, E.J.R ; Murchison, D.M. ; Rutten, E.P. ; Smeenk, F.W. ; Williams, M.C. ; Wouters, E.F.M. ; MacNee, W. / CT-measured bone attenuation in patients with chronic obstructive pulmonary disease: Relation to clinical features and outcomes. In: Journal of Bone and Mineral Research. 2013 ; Vol. 28, No. 6. pp. 1369-1377.
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abstract = "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.",
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author = "E.A.P.M. Romme and J.T. Murchison and L.D. Edwards and {van Beek}, E.J.R and D.M. Murchison and E.P. Rutten and F.W. Smeenk and M.C. Williams and E.F.M. Wouters and W. MacNee",
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Romme, EAPM, Murchison, JT, Edwards, LD, van Beek, EJR, Murchison, DM, Rutten, EP, Smeenk, FW, Williams, MC, Wouters, EFM & MacNee, W 2013, 'CT-measured bone attenuation in patients with chronic obstructive pulmonary disease: Relation to clinical features and outcomes', Journal of Bone and Mineral Research, vol. 28, no. 6, pp. 1369-1377. https://doi.org/10.1002/jbmr.1873

CT-measured bone attenuation in patients with chronic obstructive pulmonary disease: Relation to clinical features and outcomes. / Romme, E.A.P.M.; Murchison, J.T.; Edwards, L.D.; van Beek, E.J.R; Murchison, D.M.; Rutten, E.P.; Smeenk, F.W.; Williams, M.C.; Wouters, E.F.M.; MacNee, W.

In: Journal of Bone and Mineral Research, Vol. 28, No. 6, 06.2013, p. 1369-1377.

Research output: Contribution to journalArticleAcademicpeer-review

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

VL - 28

SP - 1369

EP - 1377

JO - Journal of Bone and Mineral Research

JF - Journal of Bone and Mineral Research

SN - 0884-0431

IS - 6

ER -