Male Smokers More Likely to Have Osteoporosis, Vertebral Fractures

In a study involving 3, 321 current and ex-smokers, researchers have found that men were more likely than women to have osteoporosis and fractures of their vertebrae. Smoking history and chronic obstructive pulmonary disease (COPD) were found to be independent risk factors for low bone density among both men and women. The study has just been published online in the Annals of the American Thoracic Society.

“Our findings suggest that current and past smokers of both genders should be screened for osteoporosis, ” said Elizabeth Regan, M.D., assistant professor of medicine at National Jewish Health, in the March 5, 2015 news release. “Expanding screening to include men with a smoking history and starting treatment in those with bone disease may prevent fractures, improve quality of life and reduce health care costs.”

“The growing use of CT scans to screen heavy smokers for lung cancer may provide an opportunity to use the same scans for bone density screening in this high-risk population, ” said Dr. Regan.

Dr. Regan told OTW, “There were three key findings from the research which surprised me. First, we found that former smokers had significant reductions in bone density and the current screening algorithm only considers current smokers to be at risk. Second, we found that COPD and specifically emphysema was associated with reduced bone density and fractures after adjusting for other key factors. There had been hints of this in several small studies, but the findings in this large well-characterized group of smokers provided striking evidence of the relationship. The diagnosis of COPD is not currently considered as a risk factor to justify bone density screening.”

“Finally, we expected that women would have the most severe bone disease because they have historically been shown to have more osteoporosis associated with aging. Our finding that men who are current or former smokers, actually have more bone disease and more fractures was a total surprise. It appears to me that men should be re-considered when screening decisions are addressed and careful attention should be given to the method used to assess bone density in men.”