LAUSR

monary disease (NTM-PD) is common in elderly slender women at risk of osteoporosis. This study aimed to evaluate the prevalence of osteoporosis in patients with NTM-PD and determine the factors associated with osteoporosis. Methods: We recruited 228 consecutive adult patients with NTM-PD from a prospective cohort study at Keio University Hospital, who had no history of osteoporosis or osteoporosis-associated bone fracture but underwent dualenergy X-ray absorptiometry-based bone mineral density (BMD) evaluation between August 2017 and September 2019. Estradiol (E2) and 25-hydroxyvitamin D (25OHD) levels were measured in 165 patients with available pooled serum samples. Results and Conclusions: Osteoporosis (T-score≤ 2.5) and osteopenia (T-score 1 to 2.5) were diagnosed in 34.5% and 36.8% of NTM-PD patients, respectively. Compared with the general population, the proportion of osteoporosis was significantly higher in the 50-59-, 60-69-, and 70-79-year-old women with NTM-PD. Multivariable analysis revealed that old age (adjusted odds ratio [aOR]=1.12; 95% confidence interval [CI]=1.07-1.18), female (aOR=36.3; 95% CI=7.57-174), lower BMI (aOR=1.37; 95% CI=1.14-1.65), and chronic Pseudomonas aeruginosa (PA) infection (aOR=6.70; 95% CI=1.07-41.8) were independently associated with osteoporosis. Additionally, both low E2 levels (<10 pg/mL) and lower 25OHD levels were independently associated with osteoporosis. In conclusion, middle-aged/elderly women with NTM-PD have a higher prevalence of osteoporosis than the general population. BMD screening should be considered in NTM-PD, especially in older age females with severe diseases like chronic PA infection and lower BMI, and low serum E2 and 25OHD levels.