Predictors of osteopenic syndrome in idiopathic pulmonary fibrosis


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Abstract

AIM: To evaluate the functional state of bone tissue in patients with idiopathic pulmonary fibrosis (IPF), waiting for lung transplantation, and to determine possible predictors of lower bone mineral density (BMD) in this pathology in the pre-transplantation period/MATERIAL AND METHODS: Forty-nine IPF patients waiting for lung transplantation were examined. The patients' mean age was 53.4±6.4 years. BMD in the lumbar spine (LII-LIV) and femoral neck (FN) was estimated using dual-energy X-ray absorptiometry. All the patients underwent external respiratory function test, pulmonary diffusing capacity (DLCO), gasometry, and 6-minute walk test (6'WT)/RESULTS: Osteopenia was recorded in 77% of the examinees, of them 28% had osteoporosis (OP). Normal BMD in both LII-LIV and FN was found only in 13% of the patients. The T score in LII-LIV was directly related to body mass index. There was a direct correlation between BMD in LII-LIV and FN, forced vital capacity (FVC), DLCO, and arterial blood oxygen saturation (SaO2) and an inverse correlation with arterial carbon dioxide partial pressure (pCO2). No significant correlation was found between the distance covered in 6'WT, FEV1, pO2, and BMD in both LII-LIV and FN. Six (15%) subjects had atraumatic fractures at different sites/CONCLUSION: Osteopenia is a common systemic manifestation in patients with IPF in the pre-transplantation period. BMI, FVC, exercise desaturation, and DLCO may be considered as predictors for the development of OP initiated by IPF.

About the authors

E A Kochetkova

Владивостокский государственный медицинский университет

Email: zkochetkova@mail.ru

L G Ugaĭ

Владивостокский государственный медицинский университет

Email: lg.ugay@gmail.com

V A Nevzorova

Владивостокский государственный медицинский университет

Email: nevzorova@inbox.ru

J Massard

Университетская больница, Страсбург, Франция

Email: Gilbert.Massard@chru-strasbourg.fr

References

  1. Vaquero-Barrios J.M., Arenas-de Larriva M.S., Redel-Montero J. et al. Bone mineral density in patients with chronic obstructive pulmonary disease who are candidates for lung transplant. Transplant Proceed 2010; 42: 3020-3022.
  2. Lakey W.C., Spratt S., Vinson E.N. et al. Osteoporosis in lung transplant candidates compared to matched healthy controls. Clin Transplant 2011; 25 (3): 426-435.
  3. Aris R., Lester G., Ontjes D. Treatment of bone disease in cystic fibrosis. Cur Opin Pulmon Med 2004; 10: 524-530.
  4. Tschopp O., Boehler A., Speich R. et al. Osteoporosis before lung transplantation: association with low body mass index, but not with underlying disease. Am J Transplant 2002; 2: 167-172.
  5. Caplan-Shaw C.E., Arcasoy S.M., Shawe E. et al. Osteoporosis in diffuse parenchymal lung disease. Chest 2006; 129: 140-146.
  6. Кочеткова Е.А., Майстровская Ю.В., Кесслер Р., Массард Ж. Остеопороз у пациентов с терминальной стадией легочной патологией, ожидающих трансплантацию легких. Тихоокеанский мед журнал 2009; 2: 84-87.
  7. Incalzi R.A., Caradonna P., Ranieri P. et al. Correlates of osteoporosis in chronic obstructive pulmonary disease. Respir Med 2000; 94: 1079-1084.
  8. Coin A., Sergi G., Marin S. et al. Predictors of low bone mineral density in elderly males with chronic obstructive pulmonary disease: the role of body mass index. Aging Male 2010; 13 (2): 142-147.
  9. Franco C.B., Paz-Filho G., Gomes P.E. et al. Chronic obstructive pulmonary disease is associated with osteoporosis and low levels of vitamin D. Osteoporosis Int 2009; 20 (11): 1881-1887.
  10. Vrieze A., Greef de H.M., Wykstra P.J., Wempe J.B. Low bone mineral density in COPD patients related to worse lung function, low weight and decreased fat-free mass. Osteoporosis Int 2007; 18: 1197-1202.
  11. Laet De C., Kanis J.A., Odén A. et al. Body mass index as a predictir of fracture risk: a meta-analysis. Osteoporosis Int 2005; 16: 1330-1338.
  12. Ward K.D., Klesges R.C. A meta-analysis of the effects of cigarette smoking on bone mineral density. Calcif Tissue Int 2001; 68: 259-270.
  13. Кочеткова Е.А., Волкова М.В. Функциональное состояние костной ткани у курящих и некурящих больных хронической обструктивной болезнью легких. Тер архив 2005; 3: 14-18.
  14. Dimai H.P., Domej W., Leb G. et al. Bone loss in patients with untreated chronic obstructive pulmonary disease is mediated by an increase in bone resorption associated with hypercapnia. J Bone Miner Res 2001; 16: 2132-2141.

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