On the issue of the prevalence of osteopenic syndrome in combination with COPD among residents of different altitudes of Kyrgyzstan

Background. The high incidence of osteopenia and osteoporosis in patients with chronic obstructive pulmonary disease (COPD) remains underestimated due to its asymptomatic course. According to the literature, impaired bone mineral density (BMD) in patients with COPD who have risk factors is of great interest for practical medicine and is widely studied. Taking into account the residence of the population of Kyrgyzstan at different geographical altitudes and the lack of data on the prevalence of osteopenia and osteoporosis, the study of their incidence in patients with COPD determines the relevance and objective of this study.

Objective. Evaluation of the incidence of osteopenia and osteoporosis in patients with COPD among residents of Kyrgyzstan living at different geographical altitudes.

Methods. 358 residents of Kyrgyzstan were examined. The patients were divided into 2 groups. The group 1 consisted of 158 permanent residents of the highlands (Naryn region, 1500–2500 m above sea level), mean age – 55.9±2.8 years; group 2 included 200 residents of low mountains (Bishkek, Chui Valley, 760 m above sea level), mean age – 56.0±2.8 years. Patients of groups 1 and 2 were divided into two subgroups (A and B): A – with COPD stages I–III according to GOLD, B – without respiratory pathology. BMD using T-score was determined according to the dual-energy X-ray absorptiometry data. The results were analyzed using the Statistica for Windows Version 10.0 program (Statsoft, Inc, USA). Quantitative data are presented as the mean value and its standard deviation M in the case of a normal distribution of the characteristic. Statistical significance of differences was determined at p≤0.05.

Results. In highland residents, the mean T-score was -1.9±0.1 SD, which corresponded to “osteopenia.” In residents of low mountains, the discussed indicator averaged 0.9±0.01 SD, which corresponded to the lower limit of the norm. In most cases, normal BMD values were recorded in residents of Bishkek who did not suffer from COPD. The largest number of study subjects with osteoporosis was identified among COPD patients of the first subgroups of the two groups (41.9% among residents of the Naryn region and 32.0% among residents of Bishkek, respectively). The COPD stage influenced the incidence of osteopenia. Thus, in high-altitude conditions, the largest number of patients with osteopenia (48.1%) had stage 1 COPD, in low-altitude conditions – 43.2%.

Conclusion. For residents of the highlands of Kyrgyzstan, the mean T-criterion value was -1.9±0.1 SD (“osteopenia”), for residents of the lowlands of Kyrgyzstan – 0.9±0.01 SD (lower limit of normal). In most cases, normal BMD values were recorded in residents of Bishkek who did not suffer from COPD. Among residents of the Naryn region, the largest number of patients with osteopenia had stage 1 COPD, and among residents of Bishkek – stage 2 COPD (43.2%).