BPCO E OSTEOPOROSI

COPD and osteoporosis are frequently associated because they have common risk factors, including age, smoking habits and reduced physical activity. COPD is also characterized by systemic inflammation, malnutrition (up to cachexia), hypovitaminosis D, and the use of local and systemic corticosteroids, all of which could cause deterioration in bone quality with a consequent increase in fragility fractures. These fractures may further impair mobility and increase disability and mortality. The vertebral and rib fractures can directly further affect lung function and promote exacerbations. As a result, the assessment of fracture risk in patients with COPD is of vital importance from the earliest stages of the disease by a comprehensive evaluation of risk factors, physical examination, and by means of integrated tools for assessment of fracture risk (i.e. FRAX ie, DEFRA). Even if rigorous trials specifically devoted to patients with COPD and osteoporosis are not yet available, the application of the general principles of prevention and therapy for fragility fractures is a must in these high-risk patients.