The Distribution Of Bone Mass And Mechanical Characteristics Of Bone Microstructure In Chronic Obstructive Pulmonary Disease(COPD) And The Clinical Significance

Objectives Through the analysis of bone strength(including bone mineral density and mechanical parameters of bone microstructure),to explore the bone mass distribution and mechanical characteristics of bone microstructure of chronic obstructive pulmonary disease(COPD)and the clinical significance of brittle fracture probability,and to help clinicians comprehensively assess the risk of brittle fracture in COPD patients,and to prevent and treat them as soon as possible.Methods In strict accordance with diagnostic criteria,inclusion criteria and exclusion criteria,from March 2013 to August 2021,60 COPD patients and 60 normal controls in The Affiliated Hospital of North China University of Science and Technology were collected and analyzed retrospectively.Using dual-energy X-ray absorptiometry(DXA),lumbar spine and hip BMD data were measured,and the hip bone strength analysis system(HSA)was performed to obtain the microstructrue mechanical parameters of femoral neck and intertrochanteric bone including sectional area(CSA),rotational torque(CSMI),section modulus(Z),cortical thickness(CT)and the buckling stress ratio(BR).The brittle fracture history was collected by means of film reading and medical history inquiry.Kolmogorov-smirnov test,T test and Chi-square test were used to analyze data,and P<0.05 indicated statistically significant differences.Results 1 The bone mineral density of lumbar spine(L1/2/3/4,L1-4)and hip(Femoral neck,whole hip)in COPD patients was significantly lower than that in control group(P<0.05).2 The data of CSA,Z and CT of non-dominant side femoral neck and intertrochanter in observation group were lower than control group,while non-dominant side BR was higher than control group,the difference was significant(P<0.05);The data of non-dominant side CSMI of intertrochanter in COPD patients was significantly lower than that in control group(P<0.05).3 The risk of brittle fracture of COPD patients was higher than the controls.The main fracture sites included vertebrae,hips and ribs.Lumbar and thoracic vertebrae showed more higher fracture rate,which estimated 25% and 45%,respectively;fracture incidences of the hip and rib were 18.3% and 21.7%,respectively.Conclusions In COPD patients,bone mineral density,bone microstructure mechanics and other bone strength indexes in the lumbar spine and hip are significantly decreased,which consisted with the elevated brittle fracture risks in the spine,hip and rib,especially vertebral fractures,and brittle fractures of the ribs are also common,to which need to be paid attention clinically.Figure6;Table5;Reference 148...