| Objective To explore the effect of inhaled corticosteroids on bone mineral density, bone metabolism, and fracture risk in patients with chronic obstructive pulmonary disease (COPD). Methods A total of 122 COPD patients, 70 current users of inhaled glucocorticoids and 52 who had never received glucocorticoids, were evaluated for bone mineral density (BMD), body composition, and vertebral fracture assessment (VFA). The risk factors for bone diseases considered for analysis were age, gender, inhaled glucocorticoids use, body mass index (BMI), muscle mass index (MMI), and the Global Initiative for Chronic Obstructive Lung Disease (GOLD) category. The Fracture Risk Assessment Tool (FRAX) for the Han nationality was also employed. Results Gender, BMI, MMI, GOLD class, the lowest values of the BMD T-score and Z-score, prevalence of osteoporosis, and low BMD for age were not different between the groups (P>0.05). Vertebral fractures were identified via VFA in 14 patients using inhaled corticosteroids and in none of those not receiving glucocorticoids (P<0.05). There was a trend for an association between MMI and osteoporosis (P<0.05) and for a progressive decrease in BMD Z-score according to the COPD severity assessed via the GOLD score (P>0.05), Vertebral fractures were not associated with osteoporosis (P>0.05) or low MMI (P>0.05). The fracture risk was not estimated by FRAX. Conclusion Inhaled corticosteroids causes a decrease in BMD, but no increase in fracture risk. |