Vertebral bone attenuation in Hounsfield Units and prevalent vertebral fractures are associated with the short-term risk of vertebral fractures in current and ex-smokers with and without COPD: a 3-year chest CT follow-up study

M. J. van Dort; J. H. M. Driessen; P. Geusens; E. A. P. M. Romme; F. W. J. M. Smeenk; E. F. M. Wouters; J. P. W. van den Bergh

doi:10.1007/s00198-019-04977-w

Vertebral bone attenuation in Hounsfield Units and prevalent vertebral fractures are associated with the short-term risk of vertebral fractures in current and ex-smokers with and without COPD: a 3-year chest CT follow-up study

M. J. van Dort^*, J. H. M. Driessen, P. Geusens, E. A. P. M. Romme, F. W. J. M. Smeenk, E. F. M. Wouters, J. P. W. van den Bergh

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

7 Citations (Web of Science)

Abstract

A Summary CT scans performed to evaluate chronic obstructive pulmonary disease (COPD) also enable evaluation of bone attenuation (BA; a measure of bone density) and vertebral fractures (VFs). In 1239 current/former smokers with (n=999) and without (n=240) COPD, the combination of BA and prevalent VFs was associated with the incident VF risk.

Introduction Chest CT scans are increasingly used to evaluate pulmonary diseases, including COPD. COPD patients have increased risk of osteoporosis and VFs. BA on CT scans is correlated with bone mineral density and prevalent VFs. The aim of this study was to evaluate the association between BA and prevalent VFs on chest CT scans, and the risk of incident VFs in current and former smokers with and without COPD.

Methods In participants of the ECLIPSE study with baseline and 1-year and 3-year follow-up CT scans, we evaluated BA in vertebrae T-4-T-12 and prevalent and incident VFs.

Results A total of 1239 subjects were included (mean age 61.38.0, 61.1% men, 999 (80.6%) COPD patients). The mean BA was 155.6 +/- 47.5 Hounsfield Units (HU); 253 (20.5%) had a prevalent VF and 296 (23.9%) sustained an incident VF within 3years. BA and prevalent VFs were associated with incident VFs within 1 (per -1SD HR=1.38 [1.08-1.76] and HR=3.97 [2.65-5.93] resp.) and 3 years (per -1SD HR=1.25 [1.08-1.45] and HR=3.10 [2.41-3.99] resp.), while age, sex, body mass index (BMI), smoking status and history, or presence of COPD was not. In subjects without prevalent VFs and BA, and for 1-year incidence, BMI values were associated with incident fractures (1 year, BA per -1SD HR=1.52 [1.05-2.19], BMI per SD HR=1.54 [1.13-2.11]; 3 years, per -1SD HR=1.37 [1.12-1.68]).

Conclusions On CT scans performed for pulmonary evaluation in (former) smokers with and without COPD, the combination of BA and prevalent VFs was strongly associated with the short-term risk of incident VFs.

Original language	English
Pages (from-to)	1561-1571
Number of pages	11
Journal	Osteoporosis International
Volume	30
Issue number	8
DOIs	https://doi.org/10.1007/s00198-019-04977-w
Publication status	Published - Aug 2019

Keywords

COPD
Fracture risk assessment
Osteoporosis
Screening
Tobacco smoking
OBSTRUCTIVE PULMONARY-DISEASE
MINERAL DENSITY
GLOBAL BURDEN
OSTEOPOROSIS
MEN
SMOKING
DEFORMITIES
PREDICTION
DXA

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van Dort, M. J., Driessen, J. H. M., Geusens, P., Romme, E. A. P. M., Smeenk, F. W. J. M., Wouters, E. F. M., & van den Bergh, J. P. W. (2019). Vertebral bone attenuation in Hounsfield Units and prevalent vertebral fractures are associated with the short-term risk of vertebral fractures in current and ex-smokers with and without COPD: a 3-year chest CT follow-up study. Osteoporosis International, 30(8), 1561-1571. https://doi.org/10.1007/s00198-019-04977-w

@article{82099a14e326468ba8096e5a9bbd37fc,

title = "Vertebral bone attenuation in Hounsfield Units and prevalent vertebral fractures are associated with the short-term risk of vertebral fractures in current and ex-smokers with and without COPD: a 3-year chest CT follow-up study",

abstract = "A Summary CT scans performed to evaluate chronic obstructive pulmonary disease (COPD) also enable evaluation of bone attenuation (BA; a measure of bone density) and vertebral fractures (VFs). In 1239 current/former smokers with (n=999) and without (n=240) COPD, the combination of BA and prevalent VFs was associated with the incident VF risk.Introduction Chest CT scans are increasingly used to evaluate pulmonary diseases, including COPD. COPD patients have increased risk of osteoporosis and VFs. BA on CT scans is correlated with bone mineral density and prevalent VFs. The aim of this study was to evaluate the association between BA and prevalent VFs on chest CT scans, and the risk of incident VFs in current and former smokers with and without COPD.Methods In participants of the ECLIPSE study with baseline and 1-year and 3-year follow-up CT scans, we evaluated BA in vertebrae T-4-T-12 and prevalent and incident VFs.Results A total of 1239 subjects were included (mean age 61.38.0, 61.1% men, 999 (80.6%) COPD patients). The mean BA was 155.6 +/- 47.5 Hounsfield Units (HU); 253 (20.5%) had a prevalent VF and 296 (23.9%) sustained an incident VF within 3years. BA and prevalent VFs were associated with incident VFs within 1 (per -1SD HR=1.38 [1.08-1.76] and HR=3.97 [2.65-5.93] resp.) and 3 years (per -1SD HR=1.25 [1.08-1.45] and HR=3.10 [2.41-3.99] resp.), while age, sex, body mass index (BMI), smoking status and history, or presence of COPD was not. In subjects without prevalent VFs and BA, and for 1-year incidence, BMI values were associated with incident fractures (1 year, BA per -1SD HR=1.52 [1.05-2.19], BMI per SD HR=1.54 [1.13-2.11]; 3 years, per -1SD HR=1.37 [1.12-1.68]).Conclusions On CT scans performed for pulmonary evaluation in (former) smokers with and without COPD, the combination of BA and prevalent VFs was strongly associated with the short-term risk of incident VFs.",

keywords = "COPD, Fracture risk assessment, Osteoporosis, Screening, Tobacco smoking, OBSTRUCTIVE PULMONARY-DISEASE, MINERAL DENSITY, GLOBAL BURDEN, OSTEOPOROSIS, MEN, SMOKING, DEFORMITIES, PREDICTION, DXA",

author = "{van Dort}, {M. J.} and Driessen, {J. H. M.} and P. Geusens and Romme, {E. A. P. M.} and Smeenk, {F. W. J. M.} and Wouters, {E. F. M.} and {van den Bergh}, {J. P. W.}",

year = "2019",

month = aug,

doi = "10.1007/s00198-019-04977-w",

language = "English",

volume = "30",

pages = "1561--1571",

journal = "Osteoporosis International",

issn = "0937-941X",

publisher = "Springer-Verlag London Ltd.",

number = "8",

}

van Dort, MJ, Driessen, JHM , Geusens, P, Romme, EAPM, Smeenk, FWJM , Wouters, EFM & van den Bergh, JPW 2019, 'Vertebral bone attenuation in Hounsfield Units and prevalent vertebral fractures are associated with the short-term risk of vertebral fractures in current and ex-smokers with and without COPD: a 3-year chest CT follow-up study', Osteoporosis International, vol. 30, no. 8, pp. 1561-1571. https://doi.org/10.1007/s00198-019-04977-w

Vertebral bone attenuation in Hounsfield Units and prevalent vertebral fractures are associated with the short-term risk of vertebral fractures in current and ex-smokers with and without COPD: a 3-year chest CT follow-up study. / van Dort, M. J.; Driessen, J. H. M.; Geusens, P. et al.
In: Osteoporosis International, Vol. 30, No. 8, 08.2019, p. 1561-1571.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Vertebral bone attenuation in Hounsfield Units and prevalent vertebral fractures are associated with the short-term risk of vertebral fractures in current and ex-smokers with and without COPD

T2 - a 3-year chest CT follow-up study

AU - van Dort, M. J.

AU - Driessen, J. H. M.

AU - Geusens, P.

AU - Romme, E. A. P. M.

AU - Smeenk, F. W. J. M.

AU - Wouters, E. F. M.

AU - van den Bergh, J. P. W.

PY - 2019/8

Y1 - 2019/8

N2 - A Summary CT scans performed to evaluate chronic obstructive pulmonary disease (COPD) also enable evaluation of bone attenuation (BA; a measure of bone density) and vertebral fractures (VFs). In 1239 current/former smokers with (n=999) and without (n=240) COPD, the combination of BA and prevalent VFs was associated with the incident VF risk.Introduction Chest CT scans are increasingly used to evaluate pulmonary diseases, including COPD. COPD patients have increased risk of osteoporosis and VFs. BA on CT scans is correlated with bone mineral density and prevalent VFs. The aim of this study was to evaluate the association between BA and prevalent VFs on chest CT scans, and the risk of incident VFs in current and former smokers with and without COPD.Methods In participants of the ECLIPSE study with baseline and 1-year and 3-year follow-up CT scans, we evaluated BA in vertebrae T-4-T-12 and prevalent and incident VFs.Results A total of 1239 subjects were included (mean age 61.38.0, 61.1% men, 999 (80.6%) COPD patients). The mean BA was 155.6 +/- 47.5 Hounsfield Units (HU); 253 (20.5%) had a prevalent VF and 296 (23.9%) sustained an incident VF within 3years. BA and prevalent VFs were associated with incident VFs within 1 (per -1SD HR=1.38 [1.08-1.76] and HR=3.97 [2.65-5.93] resp.) and 3 years (per -1SD HR=1.25 [1.08-1.45] and HR=3.10 [2.41-3.99] resp.), while age, sex, body mass index (BMI), smoking status and history, or presence of COPD was not. In subjects without prevalent VFs and BA, and for 1-year incidence, BMI values were associated with incident fractures (1 year, BA per -1SD HR=1.52 [1.05-2.19], BMI per SD HR=1.54 [1.13-2.11]; 3 years, per -1SD HR=1.37 [1.12-1.68]).Conclusions On CT scans performed for pulmonary evaluation in (former) smokers with and without COPD, the combination of BA and prevalent VFs was strongly associated with the short-term risk of incident VFs.

AB - A Summary CT scans performed to evaluate chronic obstructive pulmonary disease (COPD) also enable evaluation of bone attenuation (BA; a measure of bone density) and vertebral fractures (VFs). In 1239 current/former smokers with (n=999) and without (n=240) COPD, the combination of BA and prevalent VFs was associated with the incident VF risk.Introduction Chest CT scans are increasingly used to evaluate pulmonary diseases, including COPD. COPD patients have increased risk of osteoporosis and VFs. BA on CT scans is correlated with bone mineral density and prevalent VFs. The aim of this study was to evaluate the association between BA and prevalent VFs on chest CT scans, and the risk of incident VFs in current and former smokers with and without COPD.Methods In participants of the ECLIPSE study with baseline and 1-year and 3-year follow-up CT scans, we evaluated BA in vertebrae T-4-T-12 and prevalent and incident VFs.Results A total of 1239 subjects were included (mean age 61.38.0, 61.1% men, 999 (80.6%) COPD patients). The mean BA was 155.6 +/- 47.5 Hounsfield Units (HU); 253 (20.5%) had a prevalent VF and 296 (23.9%) sustained an incident VF within 3years. BA and prevalent VFs were associated with incident VFs within 1 (per -1SD HR=1.38 [1.08-1.76] and HR=3.97 [2.65-5.93] resp.) and 3 years (per -1SD HR=1.25 [1.08-1.45] and HR=3.10 [2.41-3.99] resp.), while age, sex, body mass index (BMI), smoking status and history, or presence of COPD was not. In subjects without prevalent VFs and BA, and for 1-year incidence, BMI values were associated with incident fractures (1 year, BA per -1SD HR=1.52 [1.05-2.19], BMI per SD HR=1.54 [1.13-2.11]; 3 years, per -1SD HR=1.37 [1.12-1.68]).Conclusions On CT scans performed for pulmonary evaluation in (former) smokers with and without COPD, the combination of BA and prevalent VFs was strongly associated with the short-term risk of incident VFs.

KW - COPD

KW - Fracture risk assessment

KW - Osteoporosis

KW - Screening

KW - Tobacco smoking

KW - OBSTRUCTIVE PULMONARY-DISEASE

KW - MINERAL DENSITY

KW - GLOBAL BURDEN

KW - OSTEOPOROSIS

KW - MEN

KW - SMOKING

KW - DEFORMITIES

KW - PREDICTION

KW - DXA

U2 - 10.1007/s00198-019-04977-w

DO - 10.1007/s00198-019-04977-w

M3 - Article

C2 - 31161317

SN - 0937-941X

VL - 30

SP - 1561

EP - 1571

JO - Osteoporosis International

JF - Osteoporosis International

IS - 8

ER -

van Dort MJ, Driessen JHM , Geusens P, Romme EAPM, Smeenk FWJM , Wouters EFM et al. Vertebral bone attenuation in Hounsfield Units and prevalent vertebral fractures are associated with the short-term risk of vertebral fractures in current and ex-smokers with and without COPD: a 3-year chest CT follow-up study. Osteoporosis International. 2019 Aug;30(8):1561-1571. doi: 10.1007/s00198-019-04977-w