2026-11-092026-11-09https://scholars.csmu.edu.tw/handle/123456789/38659Osteoporosis is not uncommon in patients with chronic obstructive pulmonary disease (COPD). This project is proposed to assess the bone health status among patients with COPD, and to intervene with calcium and vitamin D supplementation to explore the effects on COPD patients’ bone health status as well as their pulmonary function and physical performance. COPD patients will be recruited through outpatient clinic at CMSUH, and healthy controls will also be recruited for baseline cross-sectional comparison on bone density, bone turnover markers, urinary calcium, vitamin D nutrition status and systemic inflammation indicator. For the intervention study, corticosteroid users of COPD patients will be randomized into experimental (supplemented with 500 mg/d Ca plus 200 IU/d vitamin D3) or placebo group for 1 year. Data will be collected at 3, 6, 9, and 12 months after the initiation of intervention, and bone scan by DXA will be performed at the 6th and 12th months. In vitro experiments using cell models will also be carried to examine the potential mechanisms by which corticosteroids and Ca plus vitamin D treatment may alter osteoblasts and osteoclasts in terms of cell viability, cell cycle as well as the mRNA and protein levels of important genes. The results of the current project will provide information on the bone health problems in COPD patients, and whether COPD patients using corticosteroids will benefit from Ca+vit.D supplementation.骨質疏鬆是慢性阻塞性肺病(COPD)患者常見的合併疾病之一。本計畫嘗試對COPD 患者之骨質健康狀況進行探討，並預計以補充介入方式了解增加鈣及維生素D 的攝取 對於使用皮質類固醇類藥物之COPD 患者的骨質狀況、肺功能甚或活動能力是否有所 影響。基線(baseline)之橫斷研究將以中山醫學大學附設醫學中心胸腔內科門診之 COPD 患者為對象，與性別、年齡相仿之健康者為對照，進行骨密度檢測並收集檢體 及問卷資料以比較COPD 患者在骨密度、骨代謝指標、尿鈣排出量、維生素D 營養狀 況、發炎反應指標及體能活動量等方面之差異。鈣及維生素D 補充對照安慰劑之介入 研究將以參與之COPD 病患且使用皮質類固醇治療者，隨機分配至補充劑組(每日500 毫克鈣+200IU 維生素D)或安慰劑組。介入期間預計為一年，並將於介入期間不同時間 點收集兩組受試者的各項資料進行比較。計畫中也將建立以細胞模式探討經皮質類固 醇藥物及鈣+維生素D 處理對成骨細胞及蝕骨細胞之生命週期、存活率、重要基因之 mRNA 及蛋白質表現量所造成的影響。預期本計畫主要可提供COPD 患者骨質健康狀 況之相關流行病學資料，有助了解COPD 患者是否合併有骨質疏鬆或易發生骨折問 題，以及相關危險因子。介入試驗結果有助於了解補充鈣加維生素D 對於COPD 患者 骨質健康狀況、肺功能及活動能力是否具有改善或延緩惡化效果。細胞模式實驗則可 供了解相關機制。上述研究發現可供未來COPD 病患是否需接受骨密度或骨代謝指標 篩檢，以及是否建議病患可補充攝取鈣+維生素D 之參考依據。Project