OSTEOPOROSIS IN PATIENTS WITH COPD AND IMPACT ON QUALITY OF LIFE

Chronic obstructive pulmonary disease (COPD) is a progressive disease parenchyma destruction. Smoking is a major risk factor for this disease with frequent comorbidities. Osteoporosis is a common comorbidity in patients with COPD. Osteoporosis is characterized by lower bone density and changes in bone microarchitecture, leading to increased sensitivity and bone fractures occur. Fractures cause pain, further worsen already damaged pulmonary ventilation, reduced mobility and disability, and increased risk of thromboembolic disease, and even death. Osteoporosis in patients with COPD is probably evolving as the basis for both diseases there is systemic inflammation, but also because of the influence of inhaled tobacco smoke, reduced mobility of patients, vitamin D deficiency, lower body weight and older age. The use of systemic corticosteroids in the treatment of exacerbations of COPD increases the risk of developing osteoporosis. In addition, exacerbation of the intensification of inflammation, hypoxia and oxidative stress, as well as the imbalance between protease and anti-protease may contribute to increased bone resorption in patients with COPD. Osteoporosis can lead to kyphosis, which limits physical activity, leads to dyspnea, exacerbations and inadequate ventilation, which leads to a decrease in pulmonary function parameters. Osteoporosis can cause fractures that further limit movement, increasing the risk of thromboembolism and death. All of that have large impact on the quality of life COPD patients. Early prevention, timely diagnosis and treatment of osteoporosis are very important for patients with COPD. It is necessary significantly increase awareness of the connection between these two diseases.