Vascular Calcification in COPD Affects Bone Mineral Density, Increases Fractures

Patients with chronic obstructive pulmonary disease (COPD) have a high prevalence of vascular calcification, which is associated with low femoral neck bone mineral density (BMD) and higher rates of vertebral fractures, according to research results presented at the American Society for Bone and Mineral Research (ASBMR) 2020 Annual Meeting, held virtually from September 11 to 15, 2020.

Researchers sought to evaluate the association between osteoporosis and vertebral fragility fractures with cardiovascular calcification in patients with COPD. A total of 97 patients underwent BMD and body composition analyses via dual-energy x-ray absorptiometry, spirometric evaluation, and laboratory tests. Vertebral fractures were assessed with conventional x-ray of the thoracic and lumber spine using semiquantitative Genant’s criteria and vascular calcification of abdominal aorta using Kauppila’s method.

Of the patients included in the study, 96 had available data; 44 were men (mean age, 65.8 years) and 52 were women (mean age, 64.3 years) with mean Kauppila’s index of 4.8. A Kauppila’s index ≥7 vs <7 was associated with older age (67.9 vs 63.5 years, respectively; P <.05), lower femoral neck BMD (0.784 vs 0.877 g/cm², respectively; P <.05), and higher serum creatinine (1.0 vs 0.8 mg/dL, respectively; P <.05). In addition, more vertebral fractures (Genant’s grades 2 and 3) were seen in patients with Kauppila’s index ≥7 vs those with Kauppila’s index <7 (33.3% vs 17.5%; respectively, P =.07).

Multiple logistic regression analyses showed that age and low femoral neck BMD in women, and age and high body fat in men were the main factors contributing to a Kauppila’s index ≥7, after adjustments for confounding variables.

Researchers concluded that the high prevalence of vascular calcification in patients with COPD is associated with “low bone mass at the femoral neck and higher rates of morphometric vertebral fractures.”

Reference

Grauman R. Lower femoral neck bone mineral density and higher body fat are associated with vascular calcification in chronic obstructive pulmonary disease patients. Presented at: ASBMR 2020 Virtual Annual Meeting; September 11-15, 2020. Poster #P-018.