Association of COPD with osteoporosis in male smokers: A case control study in a tertiary medical college hospital in Bangladesh

Article type: Research Article

Authors: Bari, Mohammad Zabed Jillul^a | Patwary, Ismail^b | Hussain, Delwar^c | Islam, S.A.H.M. Mesbahul^c | Rasker, Johannes J.^{d; *}

Affiliations: [a] Department of Medicine, Sylhet MAG Osmani Medical College, Sylhet, Bangladesh | [b] Department of Medicine, Sylhet Women’s Medical College, Sylhet, Bangladesh | [c] Department of Respiratory Medicine, Sylhet MAG Osmani Medical College, Sylhet, Bangladesh | [d] University of Twente, Enschede, The Netherlands

Correspondence: [*] Corresponding author: Johannes J. Rasker, Faculty of Behavioral Management and Social Sciences, Department Psychology %****␣bmr-33-bmr181303_temp.tex␣Line␣25␣**** Health and Technology, PO Box, 217 7500AE Enschede, The Netherlands. Tel.: +31 623 628 967; E-mail: J.J.Rasker@utwente.nl.

Abstract: OBJECTIVES: Chronic obstructive pulmonary disease (COPD) may increase the risk of osteoporosis and resulting fractures can contribute to disability and mortality of patients. We intended to evaluate the frequency of osteoporosis in male smokers with and without COPD and study whether any correlation existed between osteoporosis and COPD. MATERIALS AND METHODS: This case-control study was carried out in the Department of Medicine, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh between July 2013 and June 2015. Seventy four male smokers with COPD and 66 age-matched male smokers without COPD were enrolled. All individuals underwent Bone Mass Densitometry (BMD) by Dual-Energy X-Ray Absorptiometry (DEXA). RESULTS: COPD and non-COPD groups did not differ regarding age and smoking pack-years. Osteoporosis at femoral neck (48.6% versus 16.7%; p< 0.001) and lumbar spine (68.9% versus 37.9%; p< 0.01) was significantly higher in COPD compared to controls. Osteopenia did not differ significantly. Patients with COPD were 4.5 times more likely to develop osteoporosis than controls after adjusting age, smoking-pack years and BMI (adjusted OR = 4.5; 95% CI = 1.8–11.5). CONCLUSIONS: Osteoporosis is more frequent in male smokers with COPD compared to smokers without COPD. COPD is a risk factor of osteoporosis independent of age, smoking and BMI.

Keywords: Osteoporosis, male smokers, COPD, developing country, Bangladesh

DOI: 10.3233/BMR-181303

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 1, pp. 119-125, 2020