STUDY ON RATE AND RISK FACTOR OF OSTEOPOROSIS AMONG COPD PATIENTS AT THE COPD OUTPATIENTS CLINIC – BACH MAI HOSPITAL

Abstract

Chronic obstructive pulmonary disease (COPD - Chronic Obstructive Pulmonary Disease) is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases and influenced by host factors including abnormal lung development1. COPD has been a major health challenge for global medicine because the incidence and mortality rate is increasing, with high treatment costs and the high rate of co-modibi of the disease. In Vietnam, the number of COPD patients hospitalized in The Respiratory Department of Bach Mai hospital accounts for 26%2. Osteoporosis is described by low bone mass with changes in bone microstructure, leading to a high risk of fracture. Osteoporosis is the result of a disorder between the two processes of bone formation and bone destruction, in which bone resorption predominates over bone formation. Osteoporosis is estimated to affect 200 million women worldwide, more than 75 million people in Europe, the US, and Japan3,4. The rate of osteoporosis in Asian men over 50 is 12.6%5.In Vietnam, the figure for osteoporosis is estimated at 2.8 million, accounts for 30% of women over 50 years6. COPD patients are more likely to have osteoporosis than the control group. The rate of osteoporosis and bone density reduction varies by study. The results of Jorgensen et al (2008) showed that 40.74% of COPD patients had osteoporosis, 29.62% had bone density reduction7. Shamiha et al (2014) show that up to 56.6% of COPD patients have low bone density8. Hattiholi J. and Gaude G.S.(2014) shown that 66,7% of COPD had osteoporosis and 19,6% had bone density reduction9. According to Parthasarathi et al (2011), COPD patients with low bone density accounted for 73%10. In Vietnam, the study of Nguyen Thi Thuy (2015) showed that the rate of osteoporosis was 67.7%, the rate of bone density reduction was 24.7% in COPD patients at Bach Mai Hospital11. Studies have shown that many factors cause an increase in the prevalence of osteoporosis in patients with COPD as corticosteroid use, limited mobility, decreased muscle mass, and so on. COPD patients have severely poor lung function with reduced vital capacity. When COPD is linked to osteoporosis-related fractures, the implications are devastating. With a reduced ability to move, the patient is at a higher risk of getting deep venous thrombosis and pulmonary embolism, both of which increase the chance of mortality and cause a rapid fall in the patient's health state, in addition to their already reduced quality of life12. Studies worldwide show that the rate of COPD patients with osteoporosis is very high. But now in Vietnam, this issue has not been properly addressed. Therefore in this study: Study on rate and risk factor of osteoporosis among COPD patients at the COPD outpatients clinic – Bach Mai hospital, we aim to: 1. To determine the frequency of osteoporosis in patients with COPD at the COPD outpatient clinic of Bach Mai hospital 2. To evaluate risk factors of osteoporosis in these patients