The presence of anti-GRP78 autoantibodies was also highly associated with decreased bone mineral density and osteoporosis (Figure 2A), and remained significant after multivariate adjustment for gender, airflow obstruction severity, tobacco burden, and steroid use (OR 4.2, 95%CI = 1.5–12.2, p = 0.008). This evidence concerns the gene HSPA5 and osteoporosis.