The Relationship Between Lumbar Bone Density And Lung Function In Patients With Chronic Obstructive Pulmonary Disease

Objective: To investigate the relationship between lumbar bone density and pulmonary function in patients with chronic obstructive pulmonary disease(COPD).Methods: A total of 34 cases of stable COPD were followed up from september 2015 to september 2016 in shengjing hospital,According to the world health organization(WHO)recommended standard,the patients were divided into the normal group,the bone loss and osteoporosis group measured by dual energy X ray bone mineral density instrument lumbar(L1-L4)of bone mineral density.The basic information were acquired from questionnaire investigation,and pulmonary function were measured by lung function instrument.The subjects were followed up after 3 years.Then the pulmonary function of the patients could be re-measured and re-evaluated.A statistical difference between BMI,pulmonary function indexes,the changes of pulmonary function indexes and bone density was compared in each group by anova,and the relationship between pulmonary function indexes and bone density was discussed by Pearson correlation analysis.Results: The differences of FVCpre,FVCpost,FEV1% pre and FEV1% post in the three groups were statistically significant(F values were 3.676,3.482,3.599 and 3.533,respectively;p values were all <0.05),the osteoporosis group was lower than the normal bone group and the bone loss group.The total BMD of the lumbar vertebrae in the osteoporosis group and the bone loss group decreased significantly,with statistically significant differences among the three groups(F value was 37.926;p value <0.05);The year in the osteoporosis group were more oldder than the bone loss group and the normal bone group,with statistically significant differences among the three groups(F value was 55.290;p value <0.05);There were no statistically significant differences in BMI,FVC%pre,FVC%post,FEV1 pre,FEV1post,FEV1/FVCpre,FEV1/FVCpost and improvement rate between the three groups(F values were 1.216,1.494,0.940,1.214,0.478,2.574,4.614,0.716,respectively;All p values were >0.05);Pearson correlation analysis showed that 3 years ago,total BMD of the lumbar spine of COPD patients was positively correlated with VCpre,FVCpre,FEV1 pre,FEV1/FVCpre,FEV1/FVCpost and MMEFpre(r values were 0.521,0.483,0.532,0.492,0.492 and 0.495,respectively;all p values were <0.05),and were positively correlated with FEV1 post and MMEFpost(r values were 0.611 and 0.682,respectively;All p values were <0.01),and there was no correlation between total BMD of thoracic vertebrae and lung function indicators in COPD patients before followed up(all p values were >0.05).Followed up later,the total BMD of the lumbar spine of COPD patients was positively correlated with VCpre,FVCpre,FVCpost,FEV1 pre,FEV1/FVCpre and MMEFpre(r values were 0.649,0.580,0.616,0.598,0.617 and 0.568,respectively;all p values were <0.05),and were positively correlated with FEV1 post,MMEFpost and DLCO/VA(r values were 0.584,0.564 and 0.598,respectively;All p values were <0.01)There was no correlation between the total BMD of lumbar vertebrae and the changes of pulmonary function indexes before and after followed up(all p values were >0.05).FVCpre and FEV1 decreased significantly in the osteoporosis group.The differences of(35)FVCpre?(35)FVC%pre ?(35)FVCpost and(35)FVC%post in the three groups before and after the follow-up wered statistically significant(F values were 5.616? 4.380? 5.189 and 6.451,respectively;All p values were <0.05),the changes of partial pulmonary function indexes in the osteoporosis group was significantly lower than the bone loss group and the normal bone group? Conclusion: The indexes of lumbar total bone density?partial lung function and the changes of partial lung function in the osteoporosis group were significantly lower than in the normal bone group and the bone loss group.The year in the osteoporosis group were more oldder than the bone loss group and the normal bone group.The total bone density of lumbar spine in COPD patients was correlated with some indexes of lung function,so the worse the lung function was in COPD patients,the more significant the decrease of lumbar spine density was.