TOPLINE:

Vertebral fractures — quantified using the spinal deformity index — were associated with lower percent predicted and absolute values of forced vital capacity (FVC) and total lung capacity (TLC) in patients with interstitial lung disease (ILD), independent of disease pattern and structural indices.

METHODOLOGY:

• Researchers conducted a cross-sectional study to evaluate the relationship between vertebral fractures and percent predicted FVC in patients with ILDs.
• They assessed 200 patients (mean age, 66.4 years; 51.5% men), of whom 76 had idiopathic pulmonary fibrosis, 65 had systemic sclerosis-associated ILD, 31 had idiopathic inflammatory myopathy-associated ILD, and 28 had other ILDs.
• All patients underwent high-resolution CT and pulmonary function tests that measured percent predicted FVC, TLC, diffusing capacity of carbon monoxide, and forced expiratory volume in 1 second, along with absolute values of FVC and TLC.
• Vertebral fractures from T4 to T12 were assessed using the spinal deformity index, a radiographic tool that quantifies overall vertebral fracture burden. Higher scores indicated more severe vertebral fractures and greater respiratory impairment (0 = normal and 3 = severe).

TAKEAWAY:

• Across all ILD subgroups, 23% of patients had at least one mild thoracic vertebral fracture.
• Each 1-point increase in the spinal deformity index was associated with a 2.9% reduction in percent predicted FVC and a 2.7% reduction in percent predicted TLC (P < .01 for both).
• For each 1-point increase in the spinal deformity index, FVC declined by 95.64 mL and TLC by 199.46 mL (P < .05 for both).
• Each 1-point increase in the spinal deformity index was associated with a nonsignificant reduction in percent-predicted diffusing capacity of carbon monoxide.

IN PRACTICE:

“These findings provide novel evidence of bone-lung interactions in fibrosing lung disease and support the integration of vertebral assessment into the comprehensive evaluation of ILD patients,” the authors of the study wrote.

SOURCE:

This study was led by Angelo Fassio, University of Verona, Verona, Italy. It was published online on February 9, 2026, in Respiratory Research.

LIMITATIONS:

This study was limited by its single-center, cross-sectional design and the absence of bone mineral density data from DEXA. Additionally, glucocorticoid exposure was not quantified, and the substantial prevalence of thoracic vertebral fractures (23%) may have underestimated overall skeletal fragility as fractures in regions beyond the thoracic spine were not captured.

DISCLOSURES:

This study did not receive any specific funding. Two authors reported receiving advisory board honoraria, consultancy fees, and/or speaker fees from various pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.