Chronic obstructive pulmonary disease (COPD) , an inflammatory disease of the lung, is now recognized as a systemic disease because of various systemic comorbidities beyond lung. Osteoporosis is one of such major complications. The prevalence of vertebral fractures in COPD, especially at thoracic spine, is extremely high, however, pathophysiology of bone fragility in COPD is not well understood. COPD-associated osteoporosis impairs not only quality of life but also pulmonary function itself in COPD. Thus, timely intervention would be important, but only few COPD patients are treated for osteoporosis despite existing fractures mainly because of its low awareness among health-care providers. Measures should be taken to raise the awareness of COPD-associated osteoporosis along with the elucidation of its pathophysiology.
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