Chronic Obstructive Pulmonary Disease (COPD) is one of the leading causes of mortality and loss of Disability-Adjusted Life-Years (DALYs) worldwide. It often is accompanied by the presence of various systemic comorbidities including osteoporosis which may have an impact on the course of the disease. Osteopenia and osteoporosis are the consequences of loss of Bone Mineral Density (BMD) and have been widely known major comorbidities in COPD patients. Female sex, age, and smoking are common pathogenic factors for both COPD and osteoporosis, other factors such as reduced daily physical activity, malnutrition, low body mass index, hypogonadism, vitamin D deficiency, chronic renal insufficiency, chronic hypoxemia, and drugs like corticosteroids, have been invoked to explain such a frequent association between them. Osteoporosis in COPD is however often undertreated. It has been shown in recent studies that both decreased Bone Mineral Density (BMD) and impaired bone quality contribute to bone fragility, causing fractures in COPD patients. Pulmonary function and activities of the daily life of COPD patients may be further deteriorated by osteoporosis-associated fractures. Calcium and vitamin D, hormone replacement when indicated, calcitonin, and bisphosphonate administration are few effective strategies to tackle bone loss and osteoporosis. Awareness about this high prevalence of osteoporosis in COPD patients is critically important and physicians should look for such fracture risks. Routine screening and early diagnosis of osteoporosis will enable physicians to provide the appropriate treatment to prevent fracture, which leads to improved quality of life as well as better long-term prognosis.
Osteoporosis in Chronic Obstructive Pulmonary Disease: More than just a Comorbidity