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Clinical Implications of Sarcopenia on Decreased Bone Density in Men With COPD

 Ji An Hwang  ;  Young Sam Kim  ;  Ah Young Leem,  ;  Moo Suk Park  ;  Se Kyu Kim  ;  Joon Chang  ;  Ji Ye Jung 
 CHEST, Vol.151(5) : 1018-1027, 2017 
Journal Title
Issue Date
Absorptiometry, Photon ; Aged ; Bone Diseases, Metabolic/diagnostic imaging ; Bone Diseases, Metabolic/epidemiology ; Cross-Sectional Studies ; Forced Expiratory Volume ; Humans ; Male ; Middle Aged ; Osteoporosis/diagnostic imaging ; Osteoporosis/epidemiology* ; Prevalence ; Pulmonary Disease, Chronic Obstructive/epidemiology* ; Pulmonary Disease, Chronic Obstructive/physiopathology ; Republic of Korea/epidemiology ; Sarcopenia/diagnostic imaging ; Sarcopenia/epidemiology* ; Severity of Illness Index ; Vital Capacity
COPD ; osteopenia ; osteoporosis ; sarcopenia
BACKGROUND: Sarcopenia and osteoporosis are systemic features of COPD. The present study investigated the association between sarcopenia and osteopenia/osteoporosis and the factors associated with low bone mineral density (BMD) in men with COPD.

METHODS: Data from 777 men with COPD who underwent both pulmonary function test and dual-energy x-ray absorptiometry were extracted from the Korean National Health and Nutritional Examination Survey database between 2008 and 2011. Sarcopenia was assessed with the appendicular skeletal mass index (ASMI) and osteopenia/osteoporosis with the T-score.

RESULTS: As the severity of airflow limitation increased, the prevalence of sarcopenia increased (Ptrend < .001). Additionally, as the degree of sarcopenia became severe, the prevalence of osteopenia/osteoporosis increased (Ptrend < .001), and a significant positive correlation was noted between appendicular skeletal muscle mass and BMD (ASMI/T-score: r = 0.408; P < .001). Sarcopenia was independently associated with an increased risk of low BMD in men with COPD (OR, 2.31; 95% CI, 1.53-3.46; P < .001). Old age and low fat mass were significantly associated with low BMD in both sarcopenic and non-sarcopenic participants. High serum hemoglobin and insulin levels were associated with a reduced risk of low BMD only in the sarcopenic participants, whereas exercise and dietary intake were associated with a reduced risk only in the non-sarcopenic participants.

CONCLUSIONS: Sarcopenia is closely correlated with osteopenia/osteoporosis in men with COPD. Moreover, different factors are associated with low BMD according to the presence/absence of sarcopenia in that population.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Se Kyu(김세규)
Kim, Young Sam(김영삼) ORCID logo https://orcid.org/0000-0001-9656-8482
Park, Moo Suk(박무석) ORCID logo https://orcid.org/0000-0003-0820-7615
Leem, Ah Young(임아영) ORCID logo https://orcid.org/0000-0001-5165-3704
Chang, Joon(장준) ORCID logo https://orcid.org/0000-0003-4542-6841
Jung, Ji Ye(정지예) ORCID logo https://orcid.org/0000-0003-1589-4142
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