Smoking index and COPD duration as potential risk factors for development of osteoporosis in patients with non-small cell lung cancer - A retrospective case control study evaluated by CT Hounsfield unit

Yue Zhou; Yunxiang Hu; Xixi Yan; Yueyue Zheng; Sanmao Liu; Hongmei Yao

doi:10.1016/j.heliyon.2023.e20885

Smoking index and COPD duration as potential risk factors for development of osteoporosis in patients with non-small cell lung cancer - A retrospective case control study evaluated by CT Hounsfield unit

Heliyon. 2023 Oct 10;9(10):e20885. doi: 10.1016/j.heliyon.2023.e20885. eCollection 2023 Oct.

Authors

Yue Zhou^{1

2}, Yunxiang Hu^{3

4}, Xixi Yan^{1

2}, Yueyue Zheng^{1

2}, Sanmao Liu^{3

4}, Hongmei Yao¹

Affiliations

¹ Department of Respiratory Medicine, Guizhou Provincial People's Hospital, Guizhou Province, China.
² School of Graduates, Zunyi Medical University, China.
³ Department of Orthopedics, Central Hospital of Dalian University of Technology, Dalian City, Liaoning Province, China.
⁴ School of Graduates, Dalian Medical University, China.

Abstract

Objective: To investigate the effect of smoking index (calculated as number of cigarettes per day × smoking years) and chronic obstructive pulmonary disease (COPD) duration on osteoporosis (OP)evaluated by opportunistic chest CT in patients with non-small cell lung cancer (NSCLC).

Methods: A total of 101 patients diagnosed with NSCLC were included in our cohort study. Among them, 50 patients with a history of smoking and COPD were assigned to the experimental group, while 51 patients without a history of smoking and COPD were assigned to the control group. Hounsfield unit (HU) value was measured by conventional chest CT to investigate the bone mineral density; and the mean values of axial HU value in the upper, middle and lower parts of T4, T7, T10 and L1 vertebral bodies were measured as the study variables.

Results: There were no significant differences in gender, age, body mass index, type of lung cancer, clinical stage of lung cancer and comorbidities between the two groups (P = 0.938，P = 0.158，P = 0.722,P = 0.596,P = 0.813,P = 0.655). The overall mean HU values of T4, T7, T10, L1 in the experimental group were 116.60 ± 30.67, 110.56 ± 30.03, 109.18 (96.85-122.95), 94.63 (85.20-104.12) and 106.86 ± 22.26, respectively, which were significantly lower than those in the control group (189.55 ± 34.57, 174.54 ± 35.30, 172.73 (156.33-199.50), 158.20 (141.60-179.40) and 177.50 ± 33.49) (P ＜0.05). And in the experimental group, smoking index and COPD duration were significantly and negatively correlated with HU values (r = -0.627, -0.542, P ＜0.05, respectively).

Conclusion: Patients with NSCLC who have a history of smoking and COPD exhibit a notably lower HU value compared to the control groups. Additionally, it has been observed that the smoking index and duration of COPD may be influential factors affecting bone mineral density in NSCLC patients.

Keywords: COPD; Chest CT; Hounsfield unit; NSCLC; Osteoporosis; Smoking.