There were 4,827 men who did not this website report a history of COPD or asthma and were not prescribed any medications indicated for COPD or asthma. Of the 714 men who were identified as having COPD or asthma, 434 were not prescribed corticosteroids, 103 were prescribed an oral steroid, and 177 were prescribed

inhaled corticosteroid. There were 16 men who were prescribed both an oral and inhaled corticosteroid, and they were grouped with the men who were taking oral steroids only. Duration of lung disease or corticosteroid treatment was not obtained. Bone mineral density Bone mineral density was measured at the lumbar spine, total hip, and hip subregions using dual energy X-ray absorptiometry (DXA; QDR 4500W, Hologic, Inc., Waltham, Massachusetts, USA). Lumbar spine BMD for each subject was measured in the anterior–posterior projection and calculated as the mean of the BMD from the first through fourth lumbar vertebrae. All measurements of hip DXA BMD were made on the right hip, unless, the subject reported a right hip replacement or metal objects in the right leg in which case the EPZ-6438 purchase left hip was measured. Repeat BMD were measured using the same DXA machines and methodology employed at visit 1. The percent BMD change was determined by subtracting BMD at the baseline from BMD at the follow-up visit divided by baseline

BMD and was expressed as an annualized percentage of the baseline value (percent/year). A central quality control lab, certification of DXA operators, and standardized procedures for scanning were used to insure reproducibility of DXA measurements. At baseline, a set of spine, hip, and linearity phantoms were circulated and measured at the six clinical sites. The variability across clinics was within acceptable limits, and cross calibration correction

factors were not required. To adjust for interclinic differences, statistical models include indicator variable for the individual see more scanners. Each clinic scanned a spine and hip phantom throughout the study to monitor longitudinal changes, and correction factors were applied to participant data as appropriate. The precision of DXA scans of the spine and hip is 1–2% [8]. Using normative data for young adult white males, BMD was categorized as normal, low bone mineral density, or osteoporosis, as defined by the World Health Organization [9, 10]. To calculate hip and femoral neck T-scores, mean, and SD reference values from NHANES III were used [11]. For the spine T-scores , mean and SD reference values from the Hologic database were used. Participants with a T-score ≤−2.5 SD were categorized as having osteoporosis. Fractures After the baseline examination, participants were contacted about fractures every 4 months by postcard or telephone.