[Osteoporosis in men with chronic obstructive pulmonary disease. Utility of phalangeal densitometry (AccuDEXA) as a...

To analyze the prevalence of osteoporosis in men with chronic obstructive pulmonary disease (COPD) and to evaluate whether phalangeal densitometry (AccuDEXA) could be a useful screening method for identifying osteoporosis in these patients.

We performed a cross sectional study in male patients with COPD who were assessed by a pulmonologist in primary care and in our hospital as out-patients. The diagnosis of osteoporosis was established by conventional DEXA (lumbar spine and total hip), according to the WHO criteria. Bone mineral density (BMD) was assessed by AccuDEXA. We used a ROC curve to determine the best cut-off point for screening with this technique.

One hundred fifty male patients with COPD were included. The mean age was 67 ± 3 years. The prevalence of osteoporosis by DEXA was 34%. BMD in phalanx was significantly correlated with BMD in lumbar spine and hip (r: 0.6). The sensitivity and specificity of AccuDEXA in identifying osteoporosis was 29% and 85%, respectively. The best cut-off point for AccuDEXA was a T-score of -0.8 (sensitivity 85%, specificity 63%, positive predictive value 56%, negative predictive value 89%). Glucocorticoid treatment and COPD severity were significantly associated with the presence of osteoporosis in these patients (p=0.005 and p=0.023 respectively).

The prevalence of osteoporosis in men with COPD is high. This complication seems to be associated with glucocorticoid treatment and COPD severity. AccuDEXA could be a useful screening method for osteoporosis in these patients and could almost halve the number of conventional DEXAs performed.