magazinelogo

International Journal of Clinical and Experimental Medicine Research

ISSN Online: 2575-7970 ISSN Print: 2575-7989 CODEN: IJCEMH
Frequency: bimonthly Email: ijcemr@hillpublisher.com
Total View: 2455202 Downloads: 551388 Citations: 244 (From Dimensions)
ArticleOpen Access http://dx.doi.org/10.26855/ijcemr.2024.01.005

Research Progress on Risk Factors and Treatment Strategies for the Coexistence of Osteoporosis in COPD Patients

Chunmei He, Ruicheng Hu*

Department of Respiratory Medicine, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), Changsha, Hunan, China.

*Corresponding author: Ruicheng Hu

Published: March 7,2024

Abstract

Osteoporosis (OP) is a systemic condition that can be induced by chronic obstructive pulmonary disease (COPD), further exacerbating the condition in COPD patients, impacting prognosis and quality of life, and increasing the risk of potential mortality. Early symptoms of OP are not evident, leading to potential treatment oversight. Early diagnosis of OP in COPD patients holds crucial clinical significance. This article summarizes the risk factors and treatment progress of COPD patients with concomitant OP. The risk factors for COPD patients with concomitant OP mainly include smoking, inflammatory response, age, medication effects, vitamin D deficiency, gender, lack of exercise, hypoxemia, body mass index, hormone levels, oxidative stress, and others. Currently, the basic treatment principle for COPD combined with OP is to manage both conditions simultaneously, integrating OP treatment into the COPD treatment plan. Commonly used anti-OP medications are categorized into those promoting bone formation, mineralization, and inhibiting bone resorption. Traditional Chinese medicine has also shown considerable efficacy in the treatment of COPD combined with OP.

Keywords

Chronic obstructive pulmonary disease, Osteoporosis, Risk factors, Treatment, Research progress

References

[1] Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease (2024 Report) [EB/OL]. [2024-11-12]. https://goldcopd. org/2024-gold-reports/.

[2] Liang ZY, Wang FY, Chen ZZ, et al. Key Insights into the 2023 Global Initiative for Chronic Obstructive Lung Disease (GOLD) Updates on Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. Chinese General Practice, 2023, 26(11): 1287-1298. DOI:10.12114/j.issn.1007-9572.2023.0052.

[3] Celli BR, Wedzicha JA. Update on Clinical Aspects of Chronic Obstructive Pulmonary Disease [J]. N Engl J Med, 2019, 381(13):1257-1266. doi: 10.1056/NEJMra1900500.

[4] Riley CM, Sciurba FC. Diagnosis and Outpatient Management of Chronic Obstructive Pulmonary Disease: A Review [J]. JAMA, 2019, 321(8):786-797. doi: 10.1001/jama.2019.0131.

[5] Australian Institute of Health Welfare. Chronic obstructive pulmonary disease. Canberra: Australian Institute of Health Welfare, 2020.

[6] Zhang L, Sun Y. Muscle-Bone Crosstalk in Chronic Obstructive Pulmonary Disease [J]. Front Endocrinol (Lausanne), 2021, 12:724911. doi: 10.3389/fendo.2021.724911.

[7] Sleeman A, Clements JN. Abaloparatide: A new pharmacological option for osteoporosis [J]. Am J Health Syst Pharm, 2019, 76(3):130-135. doi: 10.1093/ajhp/zxy022.

[8] Chen YW, Ramsook AH, Coxson HO, et al. Prevalence and Risk Factors for Osteoporosis in Individuals With COPD: A Systematic Review and Meta-analysis[J]. Chest, 2019, 156(6):1092-1110. doi: 10.1016/j.chest.2019.06.036. Epub 2019 Jul 25.

[9] Ayers C, Kansagara D, Lazur B, et al. Effectiveness and Safety of Treatments to Prevent Fractures in People with Low Bone Mass or Primary Osteoporosis: A Living Systematic Review and Network Meta-analysis for the American College of Physicians [J]. Ann Intern Med, 2023, 176(2):182-195. doi: 10.7326/M22-0684. Epub 2023 Jan 3. Erratum in: Ann Intern Med. 2023 Jun;176(6):884.

[10] Chinese Society of Osteoporosis and Bone Mineral Research. Diagnosis and Treatment Guidelines for Primary Osteoporosis (2017) [J]. Chinese Journal of Osteoporosis and Bone Mineral Research, 2017, 10(5): 413-443. DOI: 10.3969/j.issn.1007-9572.2017.00.118.

[11] Internal Medicine Professional Committee of the World Federation of Chinese Medicine Societies. Guidelines for the Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease with Traditional Chinese and Western Medicine (2022 Edition). Chinese Journal of Evidence-Based Medicine, 2023, 23(10): 1117-1128. doi: 10.7507/1672-2531.202304016.

[12] He HM, Cai H, Rong QF, et al. Investigation on Factors Affecting Medication Adherence in Elderly Patients with Chronic Diseases and Countermeasures. China Pharmacy, 2020, 20(10): 1622-1624. DOI: 10.11655/zgywylc2020.10.013.

[13] Huang P, Yang H, Liu H, et al. Meta-analysis of the Incidence of Osteoporosis in Chinese Patients with Chronic Obstructive Pulmonary Disease. Occupation and Health, 2022, 38(5): 690-694.

[14] Neumeier A, Keith R. Clinical Guideline Highlights for the Hospitalist: The GOLD and NICE Guidelines for the Management of COPD [J]. J Hosp Med, 2020, 15(4):240-241. doi: 10.12788/jhm.3368. Epub 2020 Feb 11.

[15] Chen Y, Xiao Y, Wen Y, et al. Smoking Reduces Bone Density in Tibetan Men: An Anatomical Study. Journal of Anatomy, 2019, 42(6): 586-588. DOI: 10.3969/j.issn.1001-1633.2019.06.012.

[16] Lu Y, Di YP, et al. Cigarette smoke-associated inflammation impairs bone remodeling through NFκB activation [J]. J Transl Med, 2021, 19(1):163. doi: 10.1186/s12967-021-02836-z.

[17] Aspera-Werz R H, Chen T, Ehnert S, et al. Cigarette smoke induces the risk of metabolic bone diseases: Transforming growth factor beta signaling impairment via dysfunctional primary cilia affects migration, proliferation, and differentiation of human mesenchymal stem cells [J]. Int J Mol Sci, 2019, 20(12):2915. doi: 10.3390/ijms20122915.

[18] Shaito A, Saliba J, Husari A, et al. Electronic Cigarette Smoke Impairs Normal Mesenchymal Stem Cell Differentiation [J]. Sci Rep, 2017, 7(1):14281. doi: 10.1038/s41598-017-14634-z.

[19] Qin Y, Liu Y, Jiang Y, et al. Cigarette smoke exposure inhibits osteoclast apoptosis via the mtROS pathway [J]. J Dent Res, 2021, 100(3):1378-1386. doi: 10.1177/00220345211009471. Epub 2021 May 12.

[20] Yu J, Li H, Ma R, et al. Pathogenesis and Therapeutic Progress in Rheumatoid Arthritis Complicated with Osteoporosis. Chinese Journal of Modern Medicine, 2020, 30(24): 51-56. DOI: 10.3969/j.issn.1005-8982.2020.24.010.

[21] Wang Y, Wang C, Liu N, et al. Influence of TNF-α on the Osteogenic Potential of Human Dental Pulp Stem Cells from Shed Deciduous Teeth. Shanghai Journal of Stomatology, 2018, 27(5): 449-454. DOI: 10.19439/j.sjos.2018.05.001.

[22] Tsukamoto M, Mori T, Nakamura E, et al. Chronic obstructive pulmonary disease severity in middle-aged and older men with osteoporosis associates with decreased bone formation [J]. Osteoporos Sarcopenia, 2020, 6(4):179-184. 

doi: 10.1016/j.afos.2020.11.003. Epub 2020 Nov 24.

[23] He Y, Chen D, Gao Q, et al. Changes in Bone Density and Related Risk Factors in Perimenopausal and Postmenopausal Women. Chinese Journal of Osteoporosis, 2019, 25(2): 185-188, 211. DOI: 10.3969/j.issn.1006-7108.2019.02.010.

[24] Zhou Y, Gu Y, Pan Y. Correlation Study on Serum Vitamin D Levels, Quality of Life, and Inflammatory Factors in Elderly Pa-tients with Chronic Obstructive Pulmonary Disease. Geriatrics & Health Care, 2018, 24(4): 408-411. 

DOI: 10.3969/j.issn.1008-8296.2018.04.014.

[25] Du J, Zhu H, Chai C, et al. Discussion on the Correlation between Chronic Obstructive Pulmonary Disease and Osteoporosis. Shaanxi Medical Journal, 2018, 47(1): 16-18. DOI: 10.3969/j.issn.1000-7377.2018.01.004.

[26] Li D, Lv S, Du W. Analysis of the Status and Influencing Factors of Osteoporosis in 541 Perimenopausal and Postmenopausal Women. Maternal and Child Health Care of China, 2022, 37(24): 4691-4694. DOI: 10.19829/j.zgfybj.issn.1001-4411.2022.24.038.

[27] Clynes MA, Harvey NC, Curtis EM, et al. The epidemiology of osteoporosis[J]. Br Med Bull, 2020, 133(1):105-117.

[28] Yang L, Chen B, Hu W, et al. Prevalence of Osteoporosis and Incidence of Osteoporotic Fractures in 1529 Middle-aged and Elderly Individuals from Multiple Communities in Guangzhou. Chinese Journal of Osteoporosis, 2018, 24(10): 1341-1345. DOI: 10.3969/j.issn.1006-7108.2018.10.016.

[29] Shuai P, Cheng Y, Liu Y, et al. Analysis of Bone Density and Osteoporosis Epidemic in the General Population in Chengdu Area. Sichuan Medical Journal, 2012, 33(9): 1680-1682. DOI: 10.3969/j.issn.1004-0501.2012.09.080.

[30] Lin X, Wang H, Xiao Q, et al. Epidemiological Investigation of Bone Loss in 717 Perimenopausal Women. Chinese Journal of Osteoporosis, 2017, 23(3): 363-367. DOI: 10.3969/j.issn.1006-7108.2017.03.018.

[31] Chen Y, Song L. Current Status of Knowledge, Self-management, and Quality of Life in Elderly Patients with Osteoporosis. Journal of Chinese Gerontology, 2012, 32(22): 4972-4974. DOI: 10.3969/j.issn.1005-9202.2012.22.055.

[32] Wang H, Dong C, Li B, Wang W, et al. Effects of Hypoxia and Reoxygenation on the Occurrence and Development of Normal Bone Tissue. Shaanxi Medical Journal, 2021, 50(6): 664-668. DOI: 10.3969/j.issn.1000-7377.2021.06.006.

[33] Cherukuri L, Kinninger A, Birudaraju D, et al. Effect of body mass index on bone mineral density is age-specific [J]. Nutr Metab Cardiovasc Dis, 2021, 31(6):1767-1773. doi: 10.1016/j.numecd.2021.02.027. Epub 2021 Mar 4.

[34] Li C, Xie YL, Su N, et al. Analysis of Bone Density and Body Composition-Related Indicators in Perimenopausal and Postmen-opausal Women in Chongqing Region. Chinese Journal of Osteoporosis, 2019, 25(12): 1765-1768, 1781. 

DOI: 10.3969/j.issn.1006-7108.2019.12.020.

[35] Głogowska-Szeląg J. Assessment of the relationship between bmd and body mass index bmi in women with postmenopausal osteoporosis [J]. Wiad Lek, 2018, 71(9):1714-1718.

[36] Song J, Zhang R, Lv L, et al. The Relationship Between Body Mass Index and Bone Mineral Density: A Mendelian Randomiza-tion Study [J]. Calcif Tissue Int, 2020, 107(5):440-445. doi: 10.1007/s00223-020-00736-w. Epub 2020 Sep 28.

[37] Liu GF, Wang ZQ, Liu L, et al. A network meta-analysis on the short-term efficacy and adverse events of different anti-osteoporosis drugs for the treatment of postmenopausal osteoporosis [J]. J Cell Biochem, 2018, 119(6):4469-4481. 

doi: 10.1002/jcb.26550.

[38] Gu H, Geng XL, Yu N. Analysis of Influencing Factors on Bone Density Levels in Perimenopausal Women. China Medical Guide, 2020, 17(29): 77-80.

[39] Domazetovic V, Marcucci G, Iantomasi T, et al. Oxidative stress in bone remodeling: role of antioxidants [J]. Clin Cases Miner Bone Metab, 2017, 14(2):209-216. doi: 10.11138/ccmbm/2017.14.1.209. Epub 2017 Oct 25.

[40] Gazzotti MR, Roco CM, Pradella CO, et al. Frequency of Osteoporosis and Vertebral Fractures in Chronic Obstructive Pulmo-nary Disease (COPD) Patients [J]. Arch Bronconeumol (Engl Ed), 2019, 55(5):252-257. English, Spanish. doi: 10.1016/j.arbres.2018.10.010. Epub 2018 Dec 9.

[41] Zhang ZY, Tian SF, Li H, et al. Correlation of Serum Vitamin D and Parathyroid Hormone Levels, Bone Density Changes with Benign Paroxysmal Positional Vertigo. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2019, 33(6): 504-507. DOI:10.13201/j.issn.1001-1781.2019.06.007.

[42] Zhu J, Tang Y, Wu Q, et al. HIF-1α facilitates osteocyte-mediated osteoclastogenesis by activating JAK2/STAT3 pathway in vitro [J]. J Cell Physiol, 2019, 234(11):21182-21192. doi: 10.1002/jcp.28721. Epub 2019 Apr 29.

[43] Ni S, Yuan Y, Qian Z, et al. Hypoxia inhibits RANKL-induced ferritinophagy and protects osteoclasts from ferroptosis[J]s. Free Radic Biol Med, 2021, 169:271-282. doi: 10.1016/j.freeradbiomed.2021.04.027. Epub 2021 Apr 22.

[44] Chen SF. Traditional Chinese Medicine Syndrome Study on Chronic Obstructive Pulmonary Disease Complicated with Second-ary Osteoporosis in Middle-aged and Elderly People in Zhongshan City. Inner Mongolia Traditional Chinese Medicine, 2017, 36(15): 21. DOI:10.3969/j.issn.1006-0979.2017.15.017.

[45] Zhang YX. Efficacy Observation of Warming Kidney, Strengthening Spleen, Promoting Blood Circulation, and Strengthening Bone Method in the Treatment of Chronic Obstructive Pulmonary Disease Complicated with Secondary Osteoporosis. Journal of Modern Chinese and Western Medicine, 2016, 25(14): 1502-1505. DOI:10.3969/j.issn.1008-8849.2016.14.007.

[46] Xie CX, Liu M, Jiang FC, et al. Observation on the Efficacy of Boshukang Granules in the Treatment of Chronic Obstructive Pulmonary Disease Complicated with Osteoporosis in the Stable Period. Chinese Medicine Guide, 2017, 23(2): 104-106.

[47] Chen SF, Huang ZY, Ling XH, et al. Efficacy of Warming Kidney and Reinforcing Lung Method in Treating Chronic Obstructive Pulmonary Disease with Lung-kidney Qi Deficiency in Stable Period. Chinese Journal of Gerontology, 2022, 42(17): 4168-4170. DOI:10.3969/j.issn.1005-9202.2022.17.010.

[48] Tao BC, Wei CJ, Bai Y, et al. Meta-analysis of Tonifying Kidney and Invigorating Spleen Method in the Treatment of Primary Osteoporosis. China Pharmacy, 2017, 28(6): 795-799. DOI:10.6039/j.issn.1001-0408.2017.06.21.

[49] Chinese Society of Osteoporosis and Mineral Disease, Chinese Medical Association. Diagnosis and Treatment Guidelines for Primary Osteoporosis (2022). Chinese Journal of General Practice, 2023, 26(14): 1671-1691. DOI:10.12114/j.issn.1007-9572.2023.0121.

[50] Barrionuevo P, Kapoor E, Asi N, et al. Efficacy of pharmacological therapies for the prevention of fractures in postmenopausal women: a network meta-analysis [J]. The Journal of Clinical Endocrinology & Metabolism, 2019, 104(5): 1623-1630. doi: 10.1210/jc.2019-00192.

[51] Chinese Society of Rehabilitation Medicine, Professional Committee for Osteoporosis Prevention and Rehabilitation. Chinese Expert Consensus on Secondary Prevention of Osteoporotic Fractures. Chinese Medical Journal, 2022, 102(45): 3581-3591. DOI:10.3760/cma.j.cn112137-20220923-02011.

[52] Traumatology Group, Chinese Orthopaedic Association. China Postoperative Standardized Anti-Osteoporosis Treatment Guide-lines for Fragility Fractures (2021). Chinese Journal of Traumatology, 2021, 23(02): 93-101. DOI:10.3760/cma.j.cn115530-20201015-00659.

[53] Sølling AS, Harsløf T, Langdahl B. Treatment with Zoledronate Subsequent to Denosumab in Osteoporosis: A 2-Year Random-ized Study [J]. J Bone Miner Res, 2021, 36(7):1245-1254. doi: 10.1002/jbmr.4305. Epub 2021 Apr 20.

[54] Vilaca T, Eastell R, Schini M. Osteoporosis in men [J]. Lancet Diabetes Endocrinol, 2022, 10(4):273-283. doi: 10.1016/S2213-8587(22)00012-2. Epub 2022 Mar 2.

[55] Zheng Wenbin. Safety Study of Oral Bisphosphonates in Moderate to Severe Chronic Kidney Disease: A Two-Country Cohort Analysis. Chinese Medical Journal, 2021, 101(6): 399.

[56] Ma L, Liu X, Sun G. Aspirin reduces the incidence of postmenopausal osteoporosis in rats through OPG-RANKL-RANK signal-ing pathway [J]. Minerva Endocrinol, 2019, 44(4):408-410. doi: 10.23736/S0391-1977.19.03067-0. Epub 2019 Oct 11.

[57] Seo IB, Lee KP, Park SY, et al. Therapeutic effect of Shinkiwhan, herbal medicine, regulates OPG/RANKL/RANK system on ovariectomy-induced bone loss rat [J]. Phys Act Nutr, 2020, 24(3):19-24. doi: 10.20463/pan.2020.0017. Epub 2020 Sep 30. PMID: 33108714;

[58] Jiang Ping, Zhao Jianan, Wei Kai, et al. Meta-analysis of the Efficacy and Safety of Tildrakizumab in Treating Osteoporosis in Patients with Rheumatoid Arthritis. Chinese Journal of Immunology, 2023, 39(9): 1928-1933. DOI: 10.3969/j.issn.1000-484X.2023.09.022.

[59] Zeng Yuling, Li Zaiqing. Effects of Different Types of Inhaled Medications on Bone Metabolism in Patients with Chronic Ob-structive Pulmonary Disease Complicated with Osteoporosis. Journal of Rational Use of Medicine, 2023, 16(2): 54-57. DOI: 10.15887/j.cnki.13-1389/r.2023.02.016.

[60] Shen Xiaoli, Zhang Canfen, Chen Lu. Impact of Zoledronic Acid Combined with Active Vitamin D and Alfacalcidol on Bone Density and Bone Metabolism Markers in Patients with Type 2 Diabetes Mellitus-Induced Osteoporosis. Zhejiang Medicine, 2022, 44(9): 945-949. DOI: 10.12056/j.issn.1006-2785.2022.44.9.2021-3374.

[61] Luo Qing, Xu Guanglan, Chen Ping, et al. Preliminary Observation of a Comprehensive Approach to Preventing Osteoporotic Compression Vertebral Fractures in Patients with COPD Complicated with Osteoporosis. Chinese Journal of Osteoporosis, 2018, 24(4): 479-482. DOI: 10.3969/j.issn.1006-7108.2018.04.012.

How to cite this paper

Research Progress on Risk Factors and Treatment Strategies for the Coexistence of Osteoporosis in COPD Patients

How to cite this paper: Chunmei He, Ruicheng Hu. (2024) Research Progress on Risk Factors and Treatment Strategies for the Coexistence of Osteoporosis in COPD PatientsInternational Journal of Clinical and Experimental Medicine Research8(1), 32-40.

DOI: http://dx.doi.org/10.26855/ijcemr.2024.01.005