The goals of this study were to determine whether bone density measured using CT (CTBD) can show significant differences in bone loss according to smoking status and pack-years, and to examine the correlation between CTBD and bone mineral density when measured by dual-energy X-ray absorptiometry (DEXA-BMD) in males without chronic obstructive pulmonary disease (COPD). In this cross-sectional study, 1,011 males without airflow obstruction ≥50 years old were included. CTBD and DEXA-BMD were compared among groups with different smoking statuses. The correlation between CTBD and DEXA-BMD and the association of CTBD with pack-years were also investigated. CTBD of all vertebral bodies (VBs) and DEXA-BMD of all VBs without L1 showed significant differences among never, former, and current smokers. CTBD was significantly lowest in ≥30-pack-year smokers and was significantly lower in ≥30-pack-year smokers than in <15-pack-year smokers (all P < 0.05). There were significant correlations between DEXA-BMD and CTBD at all VB levels (correlation coefficient [r], 0.448~0.640; all P < 0.01). A lower CTBD had a significant association with a 15 ≤ x < 30-pack-year smoking history and ≥30-pack-year smoking history, while there was no association with never-smokers. In conclusion, CTBD demonstrated significant differences in bone quality according to smoking status and pack-years in males without COPD.
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