COPD a risk factor for osteoporosis

Chronic obstructive pulmonary disease (COPD) appears to contribute to an increased risk of osteoporosis, as shown in a study.

Researchers used data from the TriNetX US Collaborative Network and looked at adult patients aged 40–65 with a COPD diagnosis, as confirmed by spirometry (FEV1/FVC <70 percent), and were followed up for a minimum of 10 years. These patients were matched to non-COPD patients using propensity scores for age, sex, BMI, smoking status, comorbidities and medication use (e, systemic corticosteroids, inhaled corticosteroids, and bone-active medications).

The primary outcome was osteoporosis, and secondary outcomes included osteoporosis with pathological fracture and pathological fractures.

The analysis included a propensity-score matched cohort of 2,682 COPD patients and 2,682 non-COPD controls. Compared with non-COPD controls, COPD patients had a nearly twofold increased risk of osteoporosis (hazard ratio [HR], 1.95, 95 percent confidence interval [CI], 1.37–2.77; p=0.0002).

Underweight status (BMI <18.5 kg/m²) was positively associated with osteoporosis risk (HR, 3.95, 95 percent CI, 2.19–7.13; p<0.0001), while male sex was highly protective (HR, 0.15, 95 percent CI, 0.14–0.16; p<0.0001).

In age-stratified analyses, the risk of osteoporosis among COPD patients increased progressively across older age groups, with the highest risk observed at ages 61–65 years (HR, 20.01, 95 percent CI, 18.77–21.33; p<0.0001).

These findings underscore the importance of incorporating systematic osteoporosis screening and monitoring into COPD management. This is especially relevant for high-risk subgroups, such as older adults, females, and those with low BMI.