COPD: 38% of patients have osteoporosis, says meta-analysis

  • Chen YW & al.
  • Chest
  • 25 Jul 2019

  • International Clinical Digest
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Takeaway

  • A meta-analysis of 58 studies finds that the pooled global prevalence of comorbid osteoporosis among patients with COPD is 38%.
  • Risk factors for comorbid osteoporosis are being underweight and having sarcopenia.

Why this matters

  • Osteoporosis in COPD is likely attributable to higher systemic inflammation.
  • Osteoporosis in COPD is largely undiagnosed until bone fractures occur.
  • Patients with COPD should be screened for osteoporosis and its risk factors.

Study design

  • Meta-analysis of 58 cohort studies (55 of which were cross-sectional), after search of EMBASE, CINAHL MEDLINE, and PubMed.
  • Funding: None disclosed.

Key results

  • Pooled global prevalence of osteoporosis was 38% (95% CI, 34%-43%) in COPD patients (I2=93%) and 15% in controls (P<.01>
  • Having COPD (vs control) increased the odds of osteoporosis (OR, 2.99; 95% CI, 2.09-4.27).
  • Risk factors for osteoporosis in COPD patients were:
    • Being underweight (BMI 2): OR, 4.26; 95% CI, 1.07-16.99.
    • Having sarcopenia: OR, 3.65; 95% CI, 1.45-9.16.
  • Decreased risk factors for osteoporosis in COPD patients were:
    • Increased BMI of 1 kg/m2: OR, 0.80; 95% CI, 0.76-0.85.
    • Increased fat-free mass index of 1 kg/m2: OR, 0.64; 95% CI, 0.49-0.83.

Limitations

  • No longitudinal studies.
  • Largely cross-sectional cohort studies.
  • High heterogeneity in prevalence of osteoporosis.