LETTER TO THE EDITOR


https://doi.org/10.5005/jp-journals-11010-1056
Indian Journal of Respiratory Care
Volume 12 | Issue 3 | Year 2023

Prevalence and Predictors of Osteoporosis in Patients of Interstitial Lung Disease: An Observational Study from North India


Mahmood D Al-Mendalawi

Department of Pediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq

Corresponding Author: Mahmood D Al-Mendalawi, Department of Pediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq, Phone: +964015548170, e-mail: mdalmendalawi@yahoo.com

How to cite this article: Al-Mendalawi MD. Prevalence and Predictors of Osteoporosis in Patients of Interstitial Lung Disease: An Observational Study from North India. Indian J Respir Care 2023;12(3):287–287.

Source of support: Nil

Conflict of interest: None

Sir,

It is worthy to comment on the study by Aggarwal et al.1 published in the October–December 2022 issue of the Indian Journal of Respiratory Care. On using the dual-energy X-ray absorptiometry (DEXA) scan, Aggarwal et al.1 studied the prevalence and predictors of osteoporosis in a cohort of Indian patients with interstitial lung disease (ILD). On referring to the World Health Organization (WHO) standard of bone mineral density (BMD), Aggarwal et al.1 reported that 40.2% of the patients had osteoporosis. The longer duration of ILD symptoms and low hemoglobin levels could predict the development of osteoporosis in the studied patients. Accordingly, Aggarwal et al.1 advocated for universal evaluation of BMD in ILD patients. Apart from a few limitations stated by Aggarwal et al.,1 we highlight the following limitation. The BMD reference values (BMDRVs) are utilized to interpret BMD readings taken by DEXA scan. Because these values are shaped by numerous parameters, notably age, gender, body weight, pubertal grade, ethnicity, and socioeconomic level,2-4 BMDRVs have been designed for many communities to be undertaken in medical practice and research institutions. Importantly, India has already formulated its BMDRVs.5 Instead of referring to the local BMDRVs in the study methodology, Aggarwal et al.1 surprisingly employed the WHO BMD standard. That limitation might further flaw the correctness of the results presented by Aggarwal et al.1 We believe that the prevalence and predictors of osteoporosis in ILD patients could be better depicted by employing local BMDRVs.

REFERENCES

1. Aggarwal D, Palta A, Jindal R, et al. Prevalence and predictors of osteoporosis in patients of interstitial lung disease: an observational study from North India. Indian J Respir Care 2022;11(4):353–357. DOI: 10.4103/ijrc.ijrc_86_22

2. Arabi A, Nabulsi M, Maalouf J, et al. Bone mineral density by age, gender, pubertal stages, and socioeconomic status in healthy Lebanese children and adolescents. Bone 2004;35(5):1169–1179. DOI: 10.1016/j.bone.2004.06.015

3. Looker AC, Melton LJ 3rd, Harris T, et al. Age, gender, and race/ethnic differences in total body and subregional bone density. Osteoporos Int 2009;20(7):1141–1149. DOI: 10.1007/s00198-008-0809-6

4. Wu Q, Lefante JJ, Rice JC, et al. Age, race, weight, and gender impact normative values of bone mineral density. Gend Med 2011;8(3):189–201. DOI: 10.1016/j.genm.2011.04.004

5. Aggarwal A, Pal R, Bhadada SK, et al. Bone mineral density in healthy adult Indian population: the Chandigarh Urban Bone Epidemiological Study (CUBES). Arch Osteoporos 2021;16(1):17. DOI: 10.1007/s11657-020-00868-4

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