COPDと骨

Crosstalk between Bone and Multiple Organs/Osteonetwork. COPD and bone.

　慢性閉塞性肺疾患（COPD）は，主にタバコ煙を長期に吸入曝露することで生じる肺の炎症性疾患であるが，骨粗鬆症をはじめとした種々の合併症を有する全身疾患と考えられている。COPDに合併する骨粗鬆症は頻度が高く，既存椎体骨折率は80％に及ぶ。しかし認知度が低く，多くが薬物治療されずに放置されている。本症の病態には不明な点が多いが，COPDでは喫煙，低体重，全身炎症，ビタミンＤ不足・欠乏，低酸素など骨粗鬆症の危険因子が重積している。本症の病態解明とともに認知度の向上が急務である。

　Chronic obstructive pulmonary disease（COPD）is a chronic inflammatory airway disease associated with various systemic comorbidities including osteoporosis. Osteoporosis is extremely common in COPD patients；up to 80％prevalence of vertebral fracture has been reported. However, its low awareness has left many patients untreated. Although pathophysiology of COPD-associated osteoporosis is largely unknown, multiple risk factors for osteoporosis are present, such as smoking, low body weight, systemic inflammation, vitamin D insufficiency, hypoxia. Further research to elucidate its pathophysiology is needed. But, more importantly, increased awareness of its significance is urgently called upon.