Loss of muscle and bone mass with increased adiposity and fractures in patients with chronic obstructive pulmonary disease: A 5-year follow-up cohort study.

Vertebral and non-vertebral fracture rates increased significantly over the 5-year follow-up period in COPD patients.

• Vertebral fracture rates increased from 22.5% at baseline to 38.5% at final assessment (P = 0.031).
• Non-vertebral fracture rates increased from 12.5% to 17.5% (P < 0.001).
• Half of the fractures occurred in patients with a BMD T-score > -2.5, indicating fractures were not limited to those with osteoporosis by densitometric criteria.
• The cohort included 40 patients with a median follow-up of 58 months.

Appendicular lean mass (ALM) decreased significantly over the follow-up period in COPD patients.

• ALM decreased from 17.5 ± 4.0 kg/m2 at baseline to 16.5 ± 4.1 kg/m2 at final assessment (P < 0.001).
• ALM was measured using DXA at both time points.
• The study cohort had a mean age of 69.0 ± 7.5 years with 21 women among the 40 patients.

Total femur bone mineral density (BMD) declined significantly over the 5-year follow-up.

• Total femur BMD decreased from 0.901 ± 0.144 g/cm2 at baseline to 0.862 ± 0.136 g/cm2 at final assessment (P < 0.001).
• BMD was measured using DXA at both baseline and final assessments.
• Baseline lumbar spine BMD was a significant predictor of bone loss at the spine (OR = 1.05, 95% CI 1.01–1.10; P = 0.037).

Fat mass index (FMI) increased significantly over the follow-up period in COPD patients.

• FMI increased from 8.5 ± 5.4 g/cm2 at baseline to 11.8 ± 5.8 g/cm2 at final assessment (P < 0.001).
• Body fat and FMI were measured using DXA at both assessments.
• Serum 25-hydroxyvitamin D < 30 ng/mL was a significant predictor of fat mass loss (OR = 8.33, 95% CI 1.16–59.93; P = 0.035).

Higher airflow obstruction was a significant predictor for the combined outcome of bone loss and incident fracture.

• Higher airflow obstruction was associated with the combined outcome of bone loss and incident fracture (OR = 22.04, 95% CI 1.17–416.52; P = 0.039).
• This finding was identified through logistic regression analysis in the cohort of 40 COPD patients.
• The wide confidence interval suggests a small sample size limiting the precision of this estimate.

Serum 25-hydroxyvitamin D levels below 30 ng/mL were a significant predictor of fat mass loss in COPD patients.

• 25-hydroxyvitamin D < 30 ng/mL predicted fat mass loss with OR = 8.33 (95% CI 1.16–59.93; P = 0.035).
• This was identified as a significant predictor in logistic regression analysis.
• The finding suggests vitamin D insufficiency may play a role in body composition changes in COPD.

The study used an observational cohort design with DXA and spine radiography with vertebral morphometry to assess musculoskeletal outcomes in COPD patients from a tertiary hospital.

• Forty patients with COPD were enrolled at baseline between November 2013 and December 2015 and reevaluated after a median follow-up of 58 months.
• Mean age was 69.0 ± 7.5 years; 21 of the 40 patients were women.
• Outcomes measured included BMD, ALM, body fat, FMI via DXA, and vertebral morphometry via spine radiography at both time points.
• The study was conducted at a tertiary hospital setting.