Factors Associated With High Prevalence of Osteoporosis in Bronchiectasis

There may be an increased prevalence of osteoporosis in patients with bronchiectasis not caused by cystic fibrosis, according to study results published in Scientific Reports. In addition, factors related to osteoporosis, including respiratory parameters, body composition, muscle strength and bone remodeling markers, were associated with a lower bone mineral density (BMD).

The study included data from patients with bronchiectasis (n=123) who were in a clinically stable state. Researchers evaluated spirometric parameters, annual exacerbations, and analysis with bone turnover markers and inflammation markers, and performed densitometry for body composition, BMD, and handgrip strength.

Of 123 patients, 65% were women, with mean age of 49.6±18.8 years and mean body mass index of 24.8±4.7 kg/m².

Researchers found that 62.8% of men and 62.5% of women had normal BMD, 30.2% and 22.2% had osteopenia, and 7% and 15% had osteoporosis. In addition, they found that 56.2% (n=52) had low fat-free mass (68.9% women and 28.6% men).

Patients with decreased bone mass had significantly reduced muscle strength, maximum expiratory volume in the first second, and vitamin D level. They also had increased levels of C-terminal telopeptide of type 1 collagen and total osteocalcin and undercarboxylated osteocalcin.

Study results indicated that there was a negative correlation between BMD and the number of serious exacerbations per year, C-terminal telopeptide of type 1 collagen, and undercarboxylated osteocalcin. There were positive correlations between BMD, fat free mass index, and handgrip dynamometry.

Limitations included the study’s single center, cross-sectional design, and the fact that the researchers did not perform a homogenous measurement of vitamin D at the end of winter.

“The conducting of prospective studies will allow a more extensive consideration of these associations,” the researchers wrote.

Reference

Contreras-Bolívar V, Olveira G, Porras N, et al. Osteopenia and osteoporosis in patients with bronchiectasis: association with respiratory parameters, body composition, muscle strength and bone remodeling biomarkers. Sci Rep. 2019;9(1):14496.