Osteoprotegerin Levels Decrease in Abstinent Alcohol-Dependent Patients

• Published in: Alcoholism, clinical and experimental research clinical and experimental research, 2016-06, Vol.40 (6), p.1235-1240
• Main Authors: Malik, Peter, von Gleissenthall, Gabriele, Gasser, Rudolf W., Moncayo, Roy, Giesinger, Johannes M., Mechtcheriakov, Sergei
• Format: Article
• Language: English
• Subjects: Adult; Alcohol Abstinence; Alcohol Dependence; Alcoholism - blood; Biomarkers - blood; Bone Density - drug effects; Bone Mineral Density; Female; Humans; Longitudinal Studies; Male; Middle Aged; Osteocalcin; Osteocalcin - blood; Osteoprotegerin; Osteoprotegerin - blood; Prospective Studies; RANK Ligand - blood; Receptor Activator of the Nuclear Factor-κB Ligand
• ISSN: 0145-6008; 1530-0277
• DOI: 10.1111/acer.13063

Background Osteoprotegerin (OPG) is a parameter of increasing interest in the search for pathophysiological mechanisms of reduced bone mineral density (BMD). It has been shown to be increased in alcohol‐dependent subjects. In our study, we wanted to examine whether changes in OPG and receptor activator of the nuclear factor‐κB ligand (RANKL) levels during an 8‐week abstinence period in alcohol‐dependent patients treated in an alcohol rehabilitation clinic would occur and whether alcohol‐related variables, smoking, status, or physical activity prior to the study served as an influence on BMD and on OPG/RANKL levels. Methods Forty‐three patients, who were abstinent not longer than a week, were included in the study. OPG and RANKL as well as other markers of bone metabolism were measured at baseline, and after 8 weeks of treatment, BMD was measured once. Results OPG levels decreased significantly, while osteocalcin, a marker of bone formation, increased significantly. RANKL as well as RANKL/OPG ratio, Serum CrossLaps, and all examined hormones showed no significant changes over time. Inflammatory parameters showed a significant reduction after 8 weeks. We detected no influence of potentially confounding variables of alcohol dependency on the course of OPG or other laboratory values. Conclusions Our results could point to the well‐known risk for reduced BMD in these patients being reversible with abstinence through an excess of bone formation. We also confirmed earlier findings that inflammatory processes play a role in the pathogenesis of alcohol‐induced disturbances in bone metabolism. Our main finding is that OPG levels decreased significantly during 8 weeks of abstinence. RANKL levels were normal at baseline and did also not change during the 8‐week observation period. RANKL/OPG ratio, being low overall, did decrease slightly, but not significantly, pointing to an excess of bone formation. OC levels increased over 8 weeks. Our results indicate an increase of bone formation during abstinence and could point to the risk for reduced BMD being reversible with abstinence.