Observational Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Feb 18, 2025; 16(2): 102101
Published online Feb 18, 2025. doi: 10.5312/wjo.v16.i2.102101
Novel association between chronic obstructive pulmonary disease and osteoporosis: A prospective cross-sectional study
Rong Gao, Jian-Kang Zeng, Kai Yang, Ping Wang, Sheng Zhou
Rong Gao, Jian-Kang Zeng, Kai Yang, Ping Wang, Sheng Zhou, First School of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou 730000, Gansu Province, China
Rong Gao, Kai Yang, Ping Wang, Sheng Zhou, Department of Diagnostic Radiology, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
Co-first authors: Rong Gao and Jian-Kang Zeng.
Author contributions: Gao R and Yang K contributed to writing and reviewing the manuscript; Gao R and Wang P contributed to designing the survey and executing the study; Gao R, Zhou S, and Wang P contributed to the statistics and reviewing the manuscript; All authors have reviewed and approved the final manuscript. Gao R and Zeng JK contributed equally to the conception and design of the study and are co-first authors.
Supported by National Natural Science Foundation of China (NSFC) of China, No. 82360358; Internal Medicine Research Project of Gansu Provincial People's Hospital, No. 22GSSYD-77; and Natural Science Foundation of Gansu Province, No. 22JR5RA659.
Institutional review board statement: Ethical approval for this study was obtained from Gansu Provincial People's Hospital, No. 2023-304.
Informed consent statement: Participants were informed about the study’s purpose, methods, and voluntary nature, with the option to withdraw at any time. By voluntarily participating, informed consent was implied. No identifiers were collected, and the anonymity and confidentiality of participants were strictly maintained.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
STROBE statement: The authors have read the STROBE Statement-a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Data sharing statement: Raw data and materials are available upon reasonable request to the Corresponding Author.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sheng Zhou, MD, Professor, Department of Diagnostic Radiology, Gansu Provincial Hospital, No. 204 Donggang West Road, Lanzhou 730000, Gansu Province, China. lzzs@sina.com
Received: October 8, 2024
Revised: December 18, 2024
Accepted: January 11, 2025
Published online: February 18, 2025
Processing time: 126 Days and 12.2 Hours
Abstract
BACKGROUND

Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition often associated with a high incidence of osteoporosis. Studies indicate that patients with COPD present with a significant decrease in bone mineral density (BMD), potentially related to inflammation and corticosteroid use.

AIM

To investigate the relationship between BMD and lung function, mainly the forced expiratory volume in the forced expiratory volume in 1 second (FEV1)/ forced vital capacity percentage (FVC%), in patients with COPD using quantitative computed tomography (QCT).

METHODS

This prospective cross-sectional study included 85 patients with COPD treated at Gansu Provincial People's Hospital. Exposure variables included lung function parameter (FEV1/FVC%), age, sex, body mass index, smoking status, tea-drinking habits, and physical activity. BMD was measured using QCT. Linear regression and generalized additive models were employed to analyze the relationship between exposure variables and BMD.

RESULTS

Linear regression analysis revealed a significant positive relationship between BMD and FEV1/FVC% (β = 0.1, 95% confidence interval [CI]: 0.1-0.1; P < 0.0001). Non-linear analysis identified a unique BMD breakpoint of 128.08 mg/cm³. Before the breakpoint, BMD was significantly positively correlated with FEV1/FVC% (β = 0.245; P = 0.0019); while after the breakpoint, the relationship was negative and showed no statistical significance (β = -0.136; P = 0.0753). This finding underscores the critical role of BMD in COPD management and highlights the importance of individualized clinical interventions in improvement of lung function and overall health status in patients.

CONCLUSION

There is a complex non-linear relationship between BMD and lung function in patients with COPD, highlighting the importance of monitoring change in bone density during the management of COPD.

Keywords: Chronic obstructive pulmonary disease; Osteoporosis; Bone mineral density; Lung function; Quantitative computed tomography; Forced expiratory volume in 1 second/forced vital capacity percentage

Core Tip: This study investigated the relationship between bone mineral density (BMD) and lung function, mainly the forced expiratory volume in 1 second (FEV1)/forced vital capacity percentage (FVC%), in patients with chronic obstructive pulmonary disease (COPD). A significant non-linear association was observed, and BMD ≤ 128.08 mg/cm³ was considered a critical threshold for lung function assessment. Higher BMD values correlated positively with higher FEV1/FVC%, suggesting that BMD may be a valuable biomarker for evaluating lung function changes in this population. These findings provide new insights into the interplay between bone health and respiratory function in patients with COPD.