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Association between alcohol consumption and both osteoporotic fracture and bone density.

Abstract

OBJECTIVE

Alcoholism is a risk factor for osteoporotic fractures and low bone density, but the effects of moderate alcohol consumption on bone are unknown. We performed a systematic review and meta-analysis to assess the associations between alcohol consumption and osteoporotic fractures, bone density and bone density loss over time, bone response to estrogen replacement, and bone remodeling.

METHODS

MEDLINE, Current Contents, PsychINFO, and Cochrane Libraries were searched for studies published before May 14, 2007. We assessed quality using the internal validity criteria of the US Preventive Services Task Force.

RESULTS

We pooled effect sizes for 2 specific outcomes (hip fracture and bone density) and synthesized data qualitatively for 4 outcomes (non-hip fracture, bone density loss over time, bone response to estrogen replacement, and bone remodeling). Compared with abstainers, persons consuming from more than 0.5 to 1.0 drinks per day had lower hip fracture risk (relative risk=0.80 [95% confidence interval, 0.71-0.91]), and persons consuming more than 2 drinks per day had higher risk (relative risk=1.39 [95% confidence interval, 1.08-1.79]). A linear relationship existed between femoral neck bone density and alcohol consumption. Because studies often combined moderate and heavier drinkers in a single category, we could not assess relative associations between alcohol consumption and bone density in moderate compared with heavy drinkers.

CONCLUSION

Compared with abstainers and heavier drinkers, persons who consume 0.5 to 1.0 drink per day have a lower risk of hip fracture. Although available evidence suggests a favorable effect of alcohol consumption on bone density, a precise range of beneficial alcohol consumption cannot be determined.

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  • Authors+Show Affiliations

    ,

    Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10467, USA. kberg@montefiore.org

    , , , , , ,

    Source

    The American journal of medicine 121:5 2008 May pg 406-18

    MeSH

    Alcohol Drinking
    Bone Density
    Dose-Response Relationship, Drug
    Ethanol
    Hip Fractures
    Humans
    Osteoporosis

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    18456037

    Citation

    Berg, Karina M., et al. "Association Between Alcohol Consumption and Both Osteoporotic Fracture and Bone Density." The American Journal of Medicine, vol. 121, no. 5, 2008, pp. 406-18.
    Berg KM, Kunins HV, Jackson JL, et al. Association between alcohol consumption and both osteoporotic fracture and bone density. Am J Med. 2008;121(5):406-18.
    Berg, K. M., Kunins, H. V., Jackson, J. L., Nahvi, S., Chaudhry, A., Harris, K. A., ... Arnsten, J. H. (2008). Association between alcohol consumption and both osteoporotic fracture and bone density. The American Journal of Medicine, 121(5), pp. 406-18. doi:10.1016/j.amjmed.2007.12.012.
    Berg KM, et al. Association Between Alcohol Consumption and Both Osteoporotic Fracture and Bone Density. Am J Med. 2008;121(5):406-18. PubMed PMID: 18456037.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Association between alcohol consumption and both osteoporotic fracture and bone density. AU - Berg,Karina M, AU - Kunins,Hillary V, AU - Jackson,Jeffrey L, AU - Nahvi,Shadi, AU - Chaudhry,Amina, AU - Harris,Kenneth A,Jr AU - Malik,Rubina, AU - Arnsten,Julia H, PY - 2007/07/26/received PY - 2007/12/21/revised PY - 2007/12/25/accepted PY - 2008/5/6/pubmed PY - 2008/5/23/medline PY - 2008/5/6/entrez SP - 406 EP - 18 JF - The American journal of medicine JO - Am. J. Med. VL - 121 IS - 5 N2 - OBJECTIVE: Alcoholism is a risk factor for osteoporotic fractures and low bone density, but the effects of moderate alcohol consumption on bone are unknown. We performed a systematic review and meta-analysis to assess the associations between alcohol consumption and osteoporotic fractures, bone density and bone density loss over time, bone response to estrogen replacement, and bone remodeling. METHODS: MEDLINE, Current Contents, PsychINFO, and Cochrane Libraries were searched for studies published before May 14, 2007. We assessed quality using the internal validity criteria of the US Preventive Services Task Force. RESULTS: We pooled effect sizes for 2 specific outcomes (hip fracture and bone density) and synthesized data qualitatively for 4 outcomes (non-hip fracture, bone density loss over time, bone response to estrogen replacement, and bone remodeling). Compared with abstainers, persons consuming from more than 0.5 to 1.0 drinks per day had lower hip fracture risk (relative risk=0.80 [95% confidence interval, 0.71-0.91]), and persons consuming more than 2 drinks per day had higher risk (relative risk=1.39 [95% confidence interval, 1.08-1.79]). A linear relationship existed between femoral neck bone density and alcohol consumption. Because studies often combined moderate and heavier drinkers in a single category, we could not assess relative associations between alcohol consumption and bone density in moderate compared with heavy drinkers. CONCLUSION: Compared with abstainers and heavier drinkers, persons who consume 0.5 to 1.0 drink per day have a lower risk of hip fracture. Although available evidence suggests a favorable effect of alcohol consumption on bone density, a precise range of beneficial alcohol consumption cannot be determined. SN - 1555-7162 UR - https://www.unboundmedicine.com/medline/citation/18456037/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9343(08)00109-5 DB - PRIME DP - Unbound Medicine ER -