Özlem BALBALOĞLU, Seyhan KARAÇAVUŞ, Yavuz Selim İNTEPE, Eylem YILDIRIM, Bayram METİN, Murat KORKMAZ

KOAH HASTALARINDA KEMİK MİNERAL YOĞUNLUĞUNUN DEĞERLENDİRİLMESİ

Amaç:Kronik obstrüktif akciğer hastalığının (KOAH) sürecinde ortaya çıkan komorbiditeler hastalığın şiddetini ve mortalitesini etkilemektedir. Osteoporozis KOAH'ın önemli bir sistemik komplikasyonudur. Çalışmamızda, hafif ve orta şiddet ki KOAH hastalarının kemik mineral yoğunluğunu (KMY) kontrol hastalarıyla karşılaştırmayı ve osteopeni/osteoporoz ile KOAH ilişkisini göstermeyi amaçladık. Gereç ve Yöntem:Çalışmada alınan hastaların dosyaları geriye dönük incelendi. KOAH tanı ve evreleri guluslararası KOAH klavuzuna göre yapıldı. Hastaların KMY parametreleri dual-enerji X-ray absorbtiometri yöntemi ile ölçüldü. Sistemik ve inhale glukokortikosteroid kullanmayan hastalar çalışmaya dahil edildi. KOAH ve kontrol grubu hastaların yaş, cinsiyet, vücut kitle indeksleri ve sigara içimi durumları eşleştirildi.Bulgular: Çalışmaya 68'i (51,1%) KOAH ve 65'i (48,9%) kontrol olmak üzere toplam 133 hasta alındı. KOAH grubunda 36 (52,9%)hasta hafif ve 32 (47,1%) hasta orta evredeydi. KOAH grubunda kontrol hastalarına göre tüm KMY değerleri anlamlı derecede düşüktü (p=0,001). Kontrol grubunda osteopeni/osteoporoz saptanmazken KOAH grubunda 48 (70,6%) hastada osteopeni ve 20 (29,4%) hastada osteoporoz mevcuttu. İki grup arasında istatistiksel olarak anlamlı fark mevcuttu (p=0,001). Hafif ve orta evre KOAH hastaları arasında KMY değerlerine göre anlamlı fark saptanmadı. Her iki evre arasında osteopeni ve osteoporoz sıklığı açısından istatistiksel olarak anlamlı fark saptanmadı (p=0,45). Sonuç:KOAH hastalarında KMY değerleri anlamlı derecede düşüktü ve osteopeni/osteoporoz sıklığı artmış bulundu. Hafif ve orta evrede ki KOAH hastalarında osteopeni/osteoporoz sıklığı yönünden fark bulunmamaktadır.

The Evaluation of Bone Mineral Density in Patients With Chronic Obstructive Pulmonary Disease

Background:Comorbidities emerging during the progress of chronic obstructive pulmonary disease (COPD) have affect on developing disease' severity and mortality.Osteoporosis is an important systemic complication of COPD. In our study, we aimed to compare bone mineral density (BMD) of control patients with mild and moderate stage of COPD patients and relationship between COPD and osteopenia/osteoporosis.Method and Method: Records of the patients taken in the study were reviewed retrospectively. Diagnosis and severity of COPD was made according to the global initiative for chronic obstructive lung disease guidelines. BMD of patients were measured with dual energy x-ray absorptiometry method. Patients who were not using inhaled or systemic glucocorticosteroid were included in the study. COPD and control group patients were matched according to age, gender, body mass index and smoking status. Results:A total number of 133 patients were included in the study which was consist of 68 (51,1%) COPD and 65 (48,9%) control patients. Mild stage patients were 36 (52,9%) and moderate were 32 (47,1%) in COPD group. All values of BMD of COPD patients were significantly lower than control group (p=0,000). Osteopenia /osteoporosis were not seen in control group while 48 (70,6%) patients had osteopenia and 20 (29,4%) patients had osteoporosis in COPD group. There was a statistically significant difference between two groups (p=0,000). BMD values were not significantly different between mild and moderate stages of COPD. Statistically significant difference was not detected between two stages according to incidince of osteopenia and osteoporosis (p=0,45).Conclusion:Values of BMD were significantly lower in COPD and incidence of osteopenia/osteoporosis was increased. There was no difference between mild and moderate stages of COPD for the incidence of osteopenia/osteoporosis.

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