High prevalence of bone disease in patients referred for pulmonary rehabilitation

There is a very high prevalence of osteopenia/osteoporosis among male patients with pulmonary disease, according to a new study from researchers in California.

"While post-menopausal women are routinely screened for osteoporosis, men are not," said Kathleen Ellstrom, PhD, RN, APRN-BC, Pulmonary Clinical Nurse Specialist and Director of the Pulmonary Rehabilitation Program at the Veterans Administration Loma Linda Healthcare System. "The high prevalence of bone disease we found in male patients referred to our pulmonary rehabilitation program suggests that routine screening should also be performed in men with pulmonary disease."

The results will be presented at the ATS 2012 International Conference in San Francisco.

The study included 46 patients, 43 of whom underwent dual-emission X-ray absorptiometry (DXA) screening. The majority (98%) of patients were male. Diagnoses included chronic obstructive pulmonary disease (COPD, 80%), idiopathic pulmonary fibrosis (IPF, 16%), and asthma (4%).

Of the 43 patients who underwent DXA scanning, 27 (63%) had positive scans. Of these 27 patients, 21 (78%) had osteopenia and 6 (22%) had osteoporosis. The severity of lung disease was also associated with bone disease as those patients with more severe lung disease were more likely to also have bone disease.

"Smoking and the use of steroids to treat exacerbations in patients with lung disease are factors known to be associated with an increased risk of osteopenia/osteoporosis. In addition, recent evidence suggests that COPD itself may be associated with an increased risk secondary to an inflammatory process independent of steroid use," said Dr. Ellstrom.

"Our findings suggest that routine screening for osteopenia/osteoporosis in male patients with pulmonary disease may help reduce the occurrence of fractures in these patients by identifying at-risk individuals that might otherwise not be evaluated and treated."