Low Bone Mineral Density and Impaired Bone Metabolism in Young Alcoholic Patients Without Liver Cirrhosis: A Cross-Sectional Study

• Published in: Alcoholism, clinical and experimental research clinical and experimental research, 2009-02, Vol.33 (2), p.375-381
• Main Authors: Malik, Peter, Gasser, Rudolf W, Kemmler, Georg, Moncayo, Roy, Finkenstedt, Gerd, Kurz, Martin, Fleischhacker, W. Wolfgang
• Format: Article
• Language: English
• Subjects: Absorptiometry, Photon; Addictive behaviors; Adult; Adult and adolescent clinical studies; Alcoholism; Alcoholism - metabolism; Alcoholism - pathology; Alcoholism and acute alcohol poisoning; Biological and medical sciences; Biomarkers; Body Mass Index; Bone and Bones - drug effects; Bone and Bones - metabolism; Bone Density; Bone Density - drug effects; Cross-Sectional Studies; Diseases of the osteoarticular system; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Liver Cirrhosis - metabolism; Liver Function Tests; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Low BMD; Male; Medical sciences; Middle Aged; Osteoporosis; Osteoporosis. Osteomalacia. Paget disease; Other diseases. Semiology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Sex Characteristics; Smoking - metabolism; Toxicology; Vitamin D Deficiency - chemically induced; Vitamin D Deficiency - epidemiology; Vitamin D Deficiency - metabolism; Young Alcoholics
• ISSN: 0145-6008; 1530-0277
• DOI: 10.1111/j.1530-0277.2008.00847.x

Background:  Osteoporosis is regularly mentioned as a consequence of alcoholism. Ethanol′s direct effect on bone‐modeling cells as well as alcoholism‐related “life‐style factors” such as malnutrition, lack of exercise, hormonal changes, and liver cirrhosis are discussed as potential causative factors. Methods:  In a cross‐sectional study, we have examined 57 noncirrhotic alcoholic patients (37 male, 20 female) aged 27 to 50 years. Patients suffering from comorbid somatic diseases and with co‐medication known to have an influence on bone mineral density (e.g., glucocorticoids, heparin, anticonvulsant agents, oral contraceptives) were excluded. We determined bone mineral density (BMD) by dual x‐ray absorptiometry (DXA) in the lumbar spine (L1–L4) and the proximal right femur (femoral neck, total hip) as well as parameters of bone metabolism. Results:  In males but not females, BMD was significantly reduced in the lumbar region, as well as in the proximal femur (femoral neck, total hip). Nine male patients (24.3% of men) and 1 female patient (5% of women) had low BMD (defined as Z‐score ≤ −2.0). As expected, there was a positive correlation between body mass index (BMI) and BMD. Alcohol‐related factors (e.g., duration of abuse, consumed amount of alcohol per day) as well as smoking were not associated with a significant effect on BMD. All of the 20 women examined showed elevated estradiol levels, which may have served as a protective factor. In this study, 75.7% of the men and 90% of the women had vitamin D insufficiency or deficiency (plasma levels of 25‐hydroxy‐vitamin D