24 Nov 2025 • A new longitudinal study showed that patients with COPD face significant declines in bone and muscle health, with fractures becoming increasingly common despite many maintaining non-osteoporotic BMD values.

Key Findings:

• Vertebral fractures increased from 22.5% to 38.5%, and non-vertebral events from 12.5% to 17.5% over five years
• Patients with T-scores greater than -2.5 accounted for half of all fractures.
• Appendicular lean mass decreased from 17.5 to 16.5 kg/m², and total femur BMD declined from 0.901 to 0.862 g/cm² (both P<0.001).
• Fat mass index increased substantially from 8.5 to 11.8 kg/m² (P<0.001), suggesting worsening body composition.
• Severe airflow obstruction markedly raised the risk of bone loss and new fractures (OR 22.04).
• Vitamin D levels <30 ng/mL were linked to greater fat mass decline (OR 8.33), while lower baseline lumbar spine BMD signaled a higher likelihood of subsequent spinal bone loss (OR 1.05).

COPD carries a substantial and underrecognized burden of musculoskeletal deterioration. Routine assessment of bone and muscle health along with proactive fracture prevention strategies should be prioritized.

Source: Springer Nature | [Read Full Story] (https://link.springer.com/article/10.1007/s00198-025-07776-8)