ORIGINAL ARTICLE Evaluation of pulmonary function and quality of life in women with osteoporosis Impe´rio Lombardi Jr. Æ Leda M. Oliveira Anamaria F. Mayer Æ Jose´ R. Jardim Æ Jamil Natour Received: 27 June 2004 / Accepted: 18 December 2004 / Published online: 2 April 2005 Ó International Osteoporosis Foundation and National Osteoporosis Foundation 2005 Abstract Osteoporotic vertebral fractures generally result in an increased kyphotic angle, which in turn may lead to disturbances in pulmonary function. The objec- tive of the present study was to evaluate pulmonary function and quality of life in a group of osteoporotic patients. Fifteen women with osteoporosis and thoracic vertebral fractures (group 1), 20 women with osteopo- rosis without vertebral fracture (group 2) and 20 control women (group 3) were submitted to spirometry using a Vitatrace-130 SL spirometer and to an SF-36 quality of life questionnaire. Women with osteoporosis and verte- bral fractures showed an increased kyphotic angle (median=60°) and decreased forced vital capacity (group 1 vs. group 2, P = 0.020; group 1 vs. group 3, P = 0.039) and forced expiratory volume in 1 s (group 1 vs. group 2, P = 0.008; group 1 vs. group 3, P = 0.014) when compared with women without vertebral fractures or osteoporosis. A negative correlation was observed between thoracic kyphosis and the predicted value of expiratory forced volume in 1 s (r =)0.713, P = 0.003). No differences in the quality of life were detected be- tween the three groups studied. We conclude that wo- men with thoracic vertebral fractures have an increased kyphotic angle and present a decrease in lung volume. Keywords Kyphosis Æ Osteoporosis Æ Pulmonary function Æ Quality of life Æ Women Introduction Osteoporosis is defined as a disease characterized by a decrease in bone mineral content and derangement in bone microarchitecture, leading to skeletal fragility with a consequent increased fracture risk [1, 2]. Osteoporotic fractures affect the musculoskeletal system and cause chronic pain, functional disability, mood changes and impairment in the quality of life. According to clinical and epidemiological studies [3, 4, 5], the severe vertebral deformation resulting from these fractures is associated with clinical signs and symptoms. One of the few studies analyzing the alterations in respiratory capacity that occur in individuals with an increased thoracic kyphotic angle reported a decline in inspiratory and vital capacity [6]. In addition, spinal deformation may result in a reduction in rib mobility and impairment of respiratory function [6]. Although the association between the intensity of osteoporotic vertebral fractures and pulmonary dysfunction is only weak at the beginning, a reduction of pulmonary func- tion can become clinically important in patients who suffer from severe osteoporosis, especially when associ- ated with heart and lung diseases of any origin [7]. Nineteen percent of women with spinal osteoporosis show increased kyphosis in the absence of thoracic vertebral fractures [8], leading to a decrease in forced vital capacity [9]. Other studies have shown that osteo- porosis-induced vertebral fractures also increase tho- racic kyphosis but, curiously, there is no mention in these cases of how lung volume is affected [10, 11]. Vertebral fractures are not always painful; when painful, they could lead to patient suffering and impair their quality of life. Some studies have demonstrated impairment in the quality of life of patients with thoracic vertebral fractures [10, 11], but no association between pain and quality of life has been found in these studies. The studies that have compared lung function, oste- oporosis and kyphosis have not stated the smoking status of their patients, and this may be a confounding Osteoporos Int (2005) 16: 1247–1253 DOI 10.1007/s00198-005-1834-3 I. Lombardi Jr. Æ L. M. Oliveira Æ J. Natour (&) Rheumatology Rehabilitation Center/Rheumatology Division, Federal University of Sa˜o Paulo, Rua Botucatu 740, 04023-900 Sa˜o Paulo, Brazil E-mail: jnatour@reumato.epm.br Tel.: +55-11-55764239 Fax: +55-11-55764239 A. F. Mayer Æ J. R. Jardim Pulmonary Rehabilitation Center/Respiratory Division, Federal University of Sa˜o Paulo, Sa˜o Paulo, Brazil