Association between arterial PaCO2 and long-term osteoporosis risk in older patients with chronic obstructive pulmonary disease
- 1Department of Emergency Medicine, People’s Hospital of Henan Province, People’s Hospital of Zhengzhou University, No. 7 Weiwu Road, Jinshui District, Zhengzhou City, Henan Province 450003 China
Abstract
Background: Osteoporosis is a highly prevalent disease among older adults. Chronic obstructive pulmonary disease (COPD) and associated hypoxia may contribute to the development of osteoporosis. This study aimed to further investigate the impact of CO₂ retention (another key pathophysiological feature of COPD) on osteoporosis, providing a novel perspective for understanding COPD-related bone metabolic disorders.
Methods: A total of 611 older patients with acute exacerbation (AE) of COPD were enrolled from the hospital’s emergency department and completed a 1-year follow-up. Arterial PaO₂, PaCO₂, FEV₁% predicted, and FEV₁/FVC were recorded at baseline (AE phase), 2-week recheck (stable COPD phase), and during AECOPD recurrence during follow-up. Lumbar spine bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry at baseline (immediately after AECOPD discharge) and at the end of follow-up. Patients were divided into the BMD-drop group (n = 231) and BMD-stable group (n = 380) based on the degree of BMD reduction during follow-up, and multivariate logistic regression was used for analysis.
Results: Adverse associations: Elevated PaCO₂ at baseline, 2-week recheck, and during AECOPD recurrence were associated with an increased risk of BMD reduction during follow-up (P<0.001, P = 0.006, P<0.001, respectively). Favorable associations: Higher PaO₂, FEV₁% predicted, and FEV₁/FVC at these three time points were associated with a decreased risk of BMD reduction during follow-up (all P<0.001).
Conclusion: Elevated arterial PaCO₂ may be associated with long-term BMD reduction in older patients with COPD and thus could represent a potential risk factor for osteoporosis in this population.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12877-026-07299-9.
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BibTeX
@article{tian2026association,
title = {{Association between arterial PaCO2 and long-term osteoporosis risk in older patients with chronic obstructive pulmonary disease}},
author = {Huijun Tian and Yanwei Cheng and Lijie Qin and Peirong Zhang and Yun Li and Bingwei Liang},
journal = {BMC Geriatrics},
year = {2026},
month = aug,
doi = {10.1186/s12877-026-07299-9},
url = {https://doi.org/10.1186/s12877-026-07299-9},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Association between arterial PaCO2 and long-term osteoporosis risk in older patients with chronic obstructive pulmonary disease
AU - Huijun Tian
AU - Yanwei Cheng
AU - Lijie Qin
AU - Peirong Zhang
AU - Yun Li
AU - Bingwei Liang
PY - 2026
DA - 2026/08/06
JO - BMC Geriatrics
DO - 10.1186/s12877-026-07299-9
UR - https://doi.org/10.1186/s12877-026-07299-9
AB - Background: Osteoporosis is a highly prevalent disease among older adults. Chronic obstructive pulmonary disease (COPD) and associated hypoxia may contribute to the development of osteoporosis. This study aimed to further investigate the impact of CO₂ retention (another key pathophysiological feature of COPD) on osteoporosis, providing a novel perspective for understanding COPD-related bone metabolic disorders. Methods: A total of 611 older patients with acute exacerbation (AE) of COPD were enrolled from the hospital’s emergency department and completed a 1-year follow-up. Arterial PaO₂, PaCO₂, FEV₁% predicted, and FEV₁/FVC were recorded at baseline (AE phase), 2-week recheck (stable COPD phase), and during AECOPD recurrence during follow-up. Lumbar spine bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry at baseline (immediately after AECOPD discharge) and at the end of follow-up. Patients were divided into the BMD-drop group (n = 231) and BMD-stable group (n = 380) based on the degree of BMD reduction during follow-up, and multivariate logistic regression was used for analysis. Results: Adverse associations: Elevated PaCO₂ at baseline, 2-week recheck, and during AECOPD recurrence were associated with an increased risk of BMD reduction during follow-up (P<0.001, P = 0.006, P<0.001, respectively). Favorable associations: Higher PaO₂, FEV₁% predicted, and FEV₁/FVC at these three time points were associated with a decreased risk of BMD reduction during follow-up (all P<0.001). Conclusion: Elevated arterial PaCO₂ may be associated with long-term BMD reduction in older patients with COPD and thus could represent a potential risk factor for osteoporosis in this population. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12877-026-07299-9.
SN - 1471-2318
ER -