Source: Annual Congress 2009 - Prognosis and comorbidities in COPD
Disease area: Airway diseases

Abstract

Backgrounds: Patients with chronic respiratory failure, especially those who are under long-term oxygen therapy (LTOT), have a higher risk for osteoporosis due to decreased exercise activity, nutritional problems, and medications such as corticosteroids. However, there is limited knowledge when and for which patient bone mineral density (BMD) should be examined.
Objective: To identify the biomarker(s) useful to predict the presence of osteoporosis in patients with chronic respiratory failure under LTOT.
Methods: Fifty patients (34 males, average age 72 years old) with chronic respiratory failure under LTOT, including 19 cases with COPD, 12 with interstitial lung diseases, 8 with brochiectasis, were recruited. Those who had been treated for osteoporosis were excluded. BMD was measured in lumber spines and femoral bones with DEXA method, and clinical parameters including pulmonary functions as well as blood and urine biomarkers related to bone metabolism were examined.
Results: Osteoporosis (BMD in femoral neck 70% of young adult mean values) was present in 18 cases (36%). BMD was correlated with age, body mass index (BMI), % vital capacity (%VC), serum levels of undercarboxylated osteocalcin (ucOC), urinary levels of type I collagen N-terminal peptides. In multivariate analysis, age, gender, BMI, %VC, serum levels of ucOC were the independent predictors of BMD.
Conclusions: In addition to known clinical parameters such as BMI, pulmonary function and ucOC levels in serum can be useful biomarkers to identify the patients who should be examined with bone mineral densitometry among the subjects with chronic respiratory failure under LTOT.

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K. Asano, H. Ogura, K. Tomomatsu, J. Miyata, M. Kodama, N. Horiuchi, S. Ueda, K. Sayama, A. Ishizaka (Tokyo, Japan). Biomarkers to predict decreased bone mineral density in patients with chronic respiratory failure. Eur Respir J 2009; 34: Suppl. 53, 519

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