• Yi-Wen Chen, Andrew H Ramsook, Harvey O Coxson, Jessica Bon, and W Darlene Reid.
• Department of Sports Medicine, China Medical University, Taichung, Taiwan. Electronic address: yiwenchen@mail.cmu.edu.tw.
• Chest. 2019 Dec 1; 156 (6): 1092-1110.

BackgroundOsteoporosis is prevalent in individuals with COPD. Updated evidence is required to complement the previous systematic review on this topic to provide best practice. The aim of this systematic review and meta-analysis was to quantitatively synthesize data from studies with respect to the prevalence and risk factors for osteoporosis among individuals with COPD.MethodsEMBASE, CINAHL, MEDLINE, and PubMed databases were searched for articles containing the key words "COPD," "osteoporosis," "prevalence," and "risk factor." Eligibility screening, data extraction, and quality assessment of the retrieved articles were conducted independently by two reviewers. Meta-analyses were performed to determine osteoporosis prevalence and risk factors in individuals with COPD. Meta-regression analyses were conducted to explore the sources of heterogeneity.ResultsThe pooled global prevalence from 58 studies was 38% (95% CI, 34-43). The presence of COPD increased the likelihood of having osteoporosis (OR, 2.83). Other significant risk factors for osteoporosis in COPD patients were BMI < 18.5 kg/m2 (OR, 4.26) and the presence of sarcopenia (OR, 3.65).ConclusionsOsteoporosis is prevalent in individuals with COPD, and the prevalence seems to be high and similar in many countries. Patients with COPD should be screened for osteoporosis and contributing risk factors.Copyright © 2019 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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