Bone stiffness and failure load are related with clinical parameters in men with chronic obstructive pulmonary disease

Authors

  • Elisabeth APM Romme,

    Corresponding author
    1. Department of Respiratory Medicine, Catharina Hospital, Eindhoven, The Netherlands
    2. Department of Respiratory Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, The Netherlands
    • Address correspondence to: Elisabeth APM Romme, MD, Maastricht University Medical Centre+, Department of Respiratory Medicine, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. E-mail: lisette.romme@catharinaziekenhuis.nl

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  • Erica PA Rutten,

    1. Program Development Centre, Centre of Expertise for Chronic Organ Failure (CIRO+), Horn, The Netherlands
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  • Piet Geusens,

    1. Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, The Netherlands
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  • Joost JA de Jong,

    1. Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
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  • Bert van Rietbergen,

    1. Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
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  • Frank WJM Smeenk,

    1. Department of Respiratory Medicine, Catharina Hospital, Eindhoven, The Netherlands
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  • Emiel FM Wouters,

    1. Department of Respiratory Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, The Netherlands
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  • Joop PW van den Bergh

    1. Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, The Netherlands
    2. Department of Internal Medicine, VieCuri Medical Centre, Venlo, The Netherlands
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ABSTRACT

Osteoporosis is frequently seen in patients with chronic obstructive pulmonary disease (COPD). Because research on bone structure and bone strength in COPD patients is limited, the objectives of this pilot study were as follows: (1) to compare bone structure, stiffness, and failure load, measured at the peripheral skeleton, between men with and without COPD after stratification for areal bone mineral density (aBMD); and (2) to relate clinical parameters with bone stiffness and failure load in men with COPD. We included 30 men with COPD (normal aBMD, n = 18; osteoporosis, n = 12) and 17 men without COPD (normal aBMD, n = 9; osteoporosis, n = 8). We assessed pack-years of smoking, body mass index (BMI), fat free mass index (FFMI), pulmonary function (forced expiratory volume in 1 second [FEV1], FEV1/forced vital capacity [FVC], diffusion capacity for carbon monoxide [DLCO], and transfer coefficient for carbon monoxide [KCO]), and extent of emphysema. Bone structure of the distal radius and tibia was assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT), and bone stiffness and failure load of the distal radius and tibia were estimated from micro finite element analysis (µFEA). After stratification for aBMD and COPD, men with osteoporosis showed abnormal bone structure (p < 0.01), lower bone stiffness (p < 0.01), and lower failure load (p < 0.01) compared with men with normal aBMD, and men with COPD had comparable bone structure, stiffness, and failure load compared with men without COPD. In men with COPD, lower FFMI was related with lower bone stiffness, and failure load of the radius and tibia and lower DLCO and KCO were related with lower bone stiffness and failure load of the tibia after normalization with respect to femoral neck aBMD. Thus, this pilot study could not detect differences in bone structure, stiffness, and failure load between men with and without COPD after stratification for aBMD. FFMI and gas transfer capacity of the lung were significantly related with bone stiffness and failure load in men with COPD after normalization with respect to femoral neck aBMD. © 2013 American Society for Bone and Mineral Research.

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