The main predictors and consequences of osteosarcopenia in COPD patients

Introduction: The term "Osteosarcopenia" has recently introduced. It includes sarcopenia and low bone mineral density. Aim: to analyze the main predictors and consequences (fracture development) of osteosarcopenia in COPD patients. Materials and Methods: In the cross-sectional study 132 patients with stable COPD (102 males/30 females, mean age 67,6 ± 8,2 years) were included. Sarcopenia and its severity were diagnosed according to the guidelines of the EWGSOP2. Muscle mass and bone mineral density were evaluated using dual energy x-ray absorptiometry (DXA). Vertebral fractures (VF) were diagnosed using semiquantitative morphometry in routine DXA. The main key risk factors were evaluated in multiple logistic regression analysis. Results: Osteosarcopenia was diagnosed in 51 (38,6%) patients. Osteoporotic fractures were present in 35 patients (26,5%). Asymptomatic VF were newly diagnosed in morphometric analyses in half of the cases (n=17), 10 patients of them had multiple VF (7,6%). 13 patients (9,9%) had severe osteosarcopenia (severe sarcopenia and osteoporotic fractures). Оsteosarcopenia was registered at any groups of COPD. However, extremely severe airway obstruction (OR=5,7 (95% CI 0,5-0,7, p=0,01)), use of systemic glucocorticoids (OR=3,4 (95% CI 1,0-10,5, p=0,03)), low BMI (OR=1,3 (95% CI 1,0-1,3, p˂0,001)), group D (OR=5,8 (95% CI 0,05-0,51, p=0,02) were the main predictors of osteosarcopenia. Conclusions: Osteosarcopenia is a frequent pathology in COPD patients and it is associated with the severity of the underlying disease, the use of systemic glucocorticoids, low BMI and extremely severe bronchial obstruction. The patients with high risk of osteosarcopenia should be examined for VF during routine DXA.