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The aim of this study was to evaluate bone mineral density (BMD) in patients with chronic obstructive pulmonary disease (COPD) with varying degrees of decreased pulmonary diffusion capacity.
Research methods: A study was conducted on 89 COPD patients, men with a long history of smoking. The average age of the patients was 60.07±5.4 years. According to the severity of bronchial obstruction, 39.33% of patients corresponded to GOLD 2, 38.2% of patients to GOLD 3, 22.47% of patients to GOLD 4. The FVD study was performed on the MasterLab/Jaeger device. The diffusing capacity of the lungs (DLCO), the ratio of the diffusing capacity of the lungs to the alveolar volume (DLCO/Va), body plethysmography, exercise tolerance (6MWD, m), and the severity of dyspnea (according to the mMRC scale) were studied. The bone mineral density (BMD) of the lumbar spine in the direct projection and the proximal femur (neck, Ward's area, greater trochanter) was assessed on a Lunar DPX-NT densitometer. Results. Patients with COPD were divided into 3 groups: group 1 with DLCO < 40%, group 2 with DLCO 40–60%, group 3 with DLCO > 60%. The lumbar spine BMD indices were the lowest in the group with severe DLCO reduction in the lungs. BMD of the Ward's area, greater trochanter, femoral neck, and proximal femur as a whole in patients with DLCO<40% significantly differed from similar indices in the group of patients with mild diffusion capacity reduction (p<0.05).
Conclusions. COPD patients with DLCO <40% were characterized by decreased BMD indices compared to BMD indices in COPD patients with DLCO>60% (p<0.05). Reliable correlations of BMD with the diffusion capacity of the lungs were established (a direct relationship of medium strength for BMD of the spine, a direct relationship of medium strength for BMD of the femoral neck). Reliable correlations of BMD with TLC and RLC (inverse relationship of medium strength) were established. During the study, reliable correlations of the diffusion capacity of the lungs with RLC and RLC/TLC (inverse relationship of medium strength for RLC, inverse relationship of medium strength for RLC/TLC) were established.
Keywords:chronic obstructive pulmonary disease; bone mineral density, osteoporosis, diffusion capacity of the lungs, pulmonary hyperinflation
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