Chronic obstructive pulmonary disease and bone health: A review on possible links and follow up studies

Chronic obstructive pulmonary disease (COPD) is a common multisystem disease mostly affecting the respiratory system. Despite the well-known pulmonary manifestations of COPD, the extrapulmonary complications are mainly demonstrated in clinical studies, and the exact mechanisms behind the relationship between COPD and some extrapulmonary manifestations are still unclear. Many case-control studies reported osteoporosis as a common complication of COPD. However, the possible causality between COPD and osteoporosis is not clearly understood, and a lack of follow-up studies on COPD patients is an important issue addressed in the literature. In the present review, we discussed the common molecular pathways in COPD and osteoporosis and summarized the follow-up studies on COPD patients evaluating the possible changes in bone mass density or the development of fractures in COPD patients.