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Vol. 1. Issue 1.
Pages 7-11 (May - June 2005)
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Vol. 1. Issue 1.
Pages 7-11 (May - June 2005)
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Osteoporosis en el varón con enfermedad pulmonar obstructiva crónica. Utilidad de la densitometría de falange (AccuDEXA) como método de cribado diagnóstico
Osteoporosis in men with chronic obstructive pulmonary disease. Utility of phalangeal densitometry (AccuDEXA) as a screening method
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E. Casadoa,
Corresponding author
ecasado@cspt.es

Correspondencia: Dr. E. Casado. Unidad de Reumatología. Hospital de Sabadell. Institut Universitari Parc Taulí (UAB). Parc Taulí s/n. 08208 Sabadell. Barcelona. España.
, M. Larrosaa, E. Navalb, M. Gallegob, A. Gómeza, C. Domingob, J. Gratacósa
a Unidad de Reumatología. Hospital de Sabadell. Institut Universitari Parc Taulí. Universidad Autónoma de Barcelona. Sabadell. Barcelona. España
b Servicio de Neumología. Hospital de Sabadell. Institut Universitari Parc Taulí. Universidad Autónoma de Barcelona. Sabadell. Barcelona. España
Article information
Objetivo

Analizar la prevalencia de osteoporosis en pacientes varones con enfermedad pulmonar obstructive crónica (EPOC) y evaluar la densitometría de falange (AccuDEXA) como método de cribado de osteoporosis en estos pacientes.

Pacientes y métodos

Estudio transversal en pacientes varones con EPOC de una consulta externa hospitalaria y de una consulta de atención primaria de neumología. El diagnóstico de osteoporosis se estableció por DEXA de columna lumbar (CL) y fémur total (FT) según criterios de la Organización Mundial de la Salud (OMS). Se determinó la densidad mineral ósea (DMO) mediante AccuDEXA. Se analizó el major punto de corte para el cribado de osteoporosis con esta técnica mediante la curva ROC.

Resultados

Se incluyeron 150 pacientes varones con EPOC. Edad media 67±3 años. La prevalencia de osteoporosis por DEXA fue del 34%. La DMO de falange presentó una buena correlación con la DMO en CL y FT (r: 0,6). La sensibilidad y especificidad de AccuDEXA para el diagnóstico de osteoporosis fue del 29 y el 85%, respectivamente. El mejor punto de corte para osteoporosis con AccuDEXA en nuestro estudio fue un T-score de –0,8 (sensibilidad, 85%; especificidad, 63%; valor predictivo positivo, 56%; valor predictivo negativo, 89%). La toma de glucocorticoides y la gravedad de la EPOC se asociaron de forma significativa con la presencia de osteoporosis (p=0,005 y p=0,023, respectivamente).

Conclusión

La prevalencia de osteoporosis en pacientes varones con EPOC es alta. Su presencia parece estar asociada al tratamiento con glucocorticoides y a la gravedad de la EPOC. AccuDEXA puede ser una técnica útil de cribado de osteoporosis en estos pacientes, que podría evitar la realización de casi la mitad de densitometrías axiales.

Palabras clave:
Osteoporosis
EPOC
Densitometría ósea
Falange
Objective

To analyze the prevalence of osteoporosis in men with chronic obstructive pulmonary disease (COPD) and to evaluate whether phalangeal densitometry (AccuDEXA) could be a useful screening method for identifying osteoporosis in these patients.

Patients and methods

We performed a cross sectional study in male patients with COPD who were assessed by a pulmonologist in primary care and in our hospital as out-patients. The diagnosis of osteoporosis was established by conventional DEXA (lumbar spine and total hip), according to the WHO criteria. Bone mineral density (BMD) was assessed by AccuDEXA. We used a ROC curve to determine the best cut-off point for screening with this technique.

Results

One hundred fifty male patients with COPD were included. The mean age was 67 ± 3 years. The prevalence of osteoporosis by DEXA was 34%. BMD in phalanx was significantly correlated with BMD in lumbar spine and hip (r: 0.6). The sensitivity and specificity of AccuDEXA in identifying osteoporosis was 29% and 85%, respectively. The best cut-off point for AccuDEXA was a T-score of –0.8 (sensitivity 85%, specificity 63%, positive predictive value 56%, negative predictive value 89%).

Glucocorticoid treatment and COPD severity were significantly associated with the presence of osteoporosis in these patients (p=0.005 and p=0.023 respectively).

Conclusion

The prevalence of osteoporosis in men with COPD is high. This complication seems to be associated with glucocorticoid treatment and COPD severity. AccuDEXA could be a useful screening method for osteoporosis in these patients and could almost halve the number of conventional DEXAs performed.

Key words:
Osteoporosis
COPD
Bone densitometry
Phalanx
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Copyright © 2005. Elsevier España S.L. Barcelona
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Reumatología Clínica (English Edition)

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