This, however, did not meet statistical significance. Table 5 Age-adjusted and multivariate-adjusteda hazard rates Protease Inhibitor Library ic50 for hip and spine and nonhip and nonspine fractures by COPD or asthma status   No COPD or asthma, (N = 4,827) COPD or asthma, no steroids (N = 434) COPD or asthma, oral steroids (N = 103) COPD or asthma, inhaled steroids (N = 177) Clinical vertebral fractures N = 74 N = 20 N = 2 N = 6  Age-adjusted 1.0 (referent) 3.17 (1.93, 5.20) 1.39 (0.34, 5.67) 2.11 (0.92, 4.85)  Model 1a 1.0 (referent) 2.98 (1.80, 4.94) 1.35 (0.33, 5.50) 2.00 (0.87, 4.61)  Model 2b 1.0 (referent) 2.64 (1.57, 4.44) 1.14 (0.28, 4.71) 1.86 (0.80, 4.32) Hip fractures N = 88 N = 11 N = 2 N = 5  Age-adjusted 1.0 (referent) 1.44 (0.77, 2.70) 1.19 (0.29, 4.82) 1.43 (0.58, 3.52)  Model 1a 1.0 (referent) 1.30 (0.68, 2.45) 1.14 (0.28, 4.63) 1.41 (0.57, 3.48)  Model 2b 1.0 (referent) 1.09 (0.56, 2.14) 0.92 (0.22, 3.77) 1.24 (0.50, 3.09) Clinical nonvertebral, nonhip fractures N = 359 N = 43 N = 4 N = 17  Age-adjusted 1.0 (referent)

1.40 (1.02, 1.91) 0.56 (0.21, 1.49) 1.30 (0.80, 2.11)  Model 1a 1.0 (referent) 1.42 (1.03, 1.96) 0.56 (0.21, 1.51) 1.29 (0.79, 2.11)  Model 2b 1.0 (referent) 1.42 (1.03, 1.96) 0.55 (0.21, 1.48) 1.28 (0.78, 2.09) Bolded cells have p values < 0.05 Ibrutinib clinical trial aAdjusted Bortezomib research buy for age, clinic, BMI, and smoking bAdjusted for age, clinic, BMI, smoking, self-reported health, alcohol (drinks per week), calcium, PASE score, coronary artery disease, stroke, and diabetes Men with COPD or asthma did not have an increased risk of hip fractures. Although men with COPD or asthma had a 12% increased risk of hip fractures (OR 1.12, 95% CI 0.55, 2.26), the OR included one and did not

meet statistical significance. In men using oral or inhaled steroids for COPD or asthma, the results were similar. Finally, men with COPD or asthma had a 42% increased risk of incident nonvertebral fractures (OR 1.42, 95% CI 1.03–1.96). Men taking oral or inhaled steroids, however, did not have an increased risk of incident nonvertebral fractures. Discussion In this cohort of community dwelling older men, COPD or asthma was associated with lower BMD at the total spine, total hip, and femoral neck, but was not associated with increased bone loss 4.5 years later. However, men with COPD or asthma had a 2.6-fold increased risk of clinical vertebral fractures and a 1.4-fold increased risk of nonvertebral fractures approximately 6 years later. Additionally, men who were prescribed with inhaled or oral corticosteroids for COPD or asthma had lower BMD at all three sites and nearly a 2-fold increased risk of osteoporosis at the spine.