{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T15:01:04Z","timestamp":1778598064508,"version":"3.51.4"},"reference-count":44,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T00:00:00Z","timestamp":1720137600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Chronic obstructive pulmonary disease has extrapulmonary manifestations, such as cardiovascular diseases and osteoporosis. The purpose of this research was to determine the relationship between the type and extent of emphysema with thoracic aorta calcification (TAC) and bone mineral density (BMD) at Th4, Th8, and L1 vertebrae. Methods: Emphysema was described by computed tomography parameters (both Fleischner classification and low attenuation value percentage, LAV%) and the clinical FEV1\/FVC ratio (Tiffeneau\u2013Pinelli index, TI, TI &lt; 0.7; TI &gt; 0.7). Results: Of 200 included patients (median age 64, 33% women), signs of clinical obstruction (TI) were observed in 104 patients, which had significantly lower BMD and more heavy TAC. BMD correlated negatively with LAV%, Rho = \u22120.16 to \u22120.23, while a positive correlation of aortic calcification with LAV% was observed, Rho = 0.30 to 0.33. Multiple linear regression showed that age and TI &lt; 0.7 were independent predictors of BMD, \u03b2 = \u22120.20 to \u22120.40, and \u03b2 = \u22120.21 to \u22120.25; age and hypercholesterolemia were independent predictors of TCA, \u03b2 = 0.61 and \u03b2 = 0.19. Conclusions: Clinical TI and morphological LAV% parameters correlated with BMD and TAC, in contrast to Fleischer-graded emphysema, which showed no correlation. However, only TI was an independent predictor of BMD, while the morphologically described type and extent of emphysema could not independently predict any extrapulmonary manifestation.<\/jats:p>","DOI":"10.3390\/jcm13133947","type":"journal-article","created":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T12:30:59Z","timestamp":1720182659000},"page":"3947","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Is Type and Grade of Emphysema Important for Bone Mineral Density and Aortic Calcifications?"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6201-9353","authenticated-orcid":false,"given":"Danica","family":"Vukovi\u0107","sequence":"first","affiliation":[{"name":"Clinical Department of Diagnostic and Interventional Radiology, University Hospital Split, \u0160oltanska 2, 21000 Split, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1362-2901","authenticated-orcid":false,"given":"Danijela","family":"Budimir Mr\u0161i\u0107","sequence":"additional","affiliation":[{"name":"Clinical Department of Diagnostic and Interventional Radiology, University Hospital Split, \u0160oltanska 2, 21000 Split, Croatia"},{"name":"School of Medicine, University of Split, \u0160oltanska 2, 21000 Split, Croatia"},{"name":"University Department of Health Studies, University of Split, Ru\u0111era Bo\u0161kovi\u0107a 35, 21000 Split, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8799-9413","authenticated-orcid":false,"given":"Ivan","family":"Ordulj","sequence":"additional","affiliation":[{"name":"Clinical Department of Diagnostic and Interventional Radiology, University Hospital Split, \u0160oltanska 2, 21000 Split, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2923-0908","authenticated-orcid":false,"given":"Frano","family":"\u0160ari\u0107","sequence":"additional","affiliation":[{"name":"Clinical Department of Diagnostic and Interventional Radiology, University Hospital Split, \u0160oltanska 2, 21000 Split, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirko","family":"Tandara","sequence":"additional","affiliation":[{"name":"Clinical Department of Diagnostic and Interventional Radiology, University Hospital Split, \u0160oltanska 2, 21000 Split, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2737-0103","authenticated-orcid":false,"given":"Kristian","family":"Jerkovi\u0107","sequence":"additional","affiliation":[{"name":"Clinical Department of Diagnostic and Interventional Radiology, University Hospital Split, \u0160oltanska 2, 21000 Split, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonela","family":"Matana","sequence":"additional","affiliation":[{"name":"University Department of Health Studies, University of Split, Ru\u0111era Bo\u0161kovi\u0107a 35, 21000 Split, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tade","family":"Tadi\u0107","sequence":"additional","affiliation":[{"name":"Clinical Department of Diagnostic and Interventional Radiology, University Hospital Split, \u0160oltanska 2, 21000 Split, Croatia"},{"name":"School of Medicine, University of Split, \u0160oltanska 2, 21000 Split, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.thorsurg.2009.03.003","article-title":"The Epidemiology, Etiology, Clinical Features, and Natural History of Emphysema","volume":"19","author":"Kemp","year":"2009","journal-title":"Thorac. 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