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Low bone mineral density and impaired bone metabolism in young alcoholic patients without liver cirrhosis: a cross-sectional study.
Alcohol Clin Exp Res 2009; 33(2):375-81AC

Abstract

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 < or = -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 < 30 ng/ml).

CONCLUSIONS

Our study indicates that younger alcoholic patients without other diseases may suffer from an increased risk to develop low BMD and a disturbance of vitamin D metabolism. Nutritional factors or less exposure to sunlight may play an important role in bone loss in young alcoholic patients. BMD measurement and assessment of bone metabolism should be considered in all patients with chronic alcoholism.

Authors+Show Affiliations

Department of Biological Psychiatry, Medical University Innsbruck, Anichstrasse 35, Innsbruck, Austria. peter.malik@i-med.ac.atNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19053976

Citation

Malik, Peter, et al. "Low Bone Mineral Density and Impaired Bone Metabolism in Young Alcoholic Patients Without Liver Cirrhosis: a Cross-sectional Study." Alcoholism, Clinical and Experimental Research, vol. 33, no. 2, 2009, pp. 375-81.
Malik P, Gasser RW, Kemmler G, et al. Low bone mineral density and impaired bone metabolism in young alcoholic patients without liver cirrhosis: a cross-sectional study. Alcohol Clin Exp Res. 2009;33(2):375-81.
Malik, P., Gasser, R. W., Kemmler, G., Moncayo, R., Finkenstedt, G., Kurz, M., & Fleischhacker, W. W. (2009). Low bone mineral density and impaired bone metabolism in young alcoholic patients without liver cirrhosis: a cross-sectional study. Alcoholism, Clinical and Experimental Research, 33(2), pp. 375-81. doi:10.1111/j.1530-0277.2008.00847.x.
Malik P, et al. Low Bone Mineral Density and Impaired Bone Metabolism in Young Alcoholic Patients Without Liver Cirrhosis: a Cross-sectional Study. Alcohol Clin Exp Res. 2009;33(2):375-81. PubMed PMID: 19053976.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low bone mineral density and impaired bone metabolism in young alcoholic patients without liver cirrhosis: a cross-sectional study. AU - Malik,Peter, AU - Gasser,Rudolf W, AU - Kemmler,Georg, AU - Moncayo,Roy, AU - Finkenstedt,Gerd, AU - Kurz,Martin, AU - Fleischhacker,W Wolfgang, Y1 - 2008/11/25/ PY - 2008/12/5/pubmed PY - 2009/4/11/medline PY - 2008/12/5/entrez SP - 375 EP - 81 JF - Alcoholism, clinical and experimental research JO - Alcohol. Clin. Exp. Res. VL - 33 IS - 2 N2 - 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 < or = -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 < 30 ng/ml). CONCLUSIONS: Our study indicates that younger alcoholic patients without other diseases may suffer from an increased risk to develop low BMD and a disturbance of vitamin D metabolism. Nutritional factors or less exposure to sunlight may play an important role in bone loss in young alcoholic patients. BMD measurement and assessment of bone metabolism should be considered in all patients with chronic alcoholism. SN - 1530-0277 UR - https://www.unboundmedicine.com/medline/citation/19053976/Low_bone_mineral_density_and_impaired_bone_metabolism_in_young_alcoholic_patients_without_liver_cirrhosis:_a_cross_sectional_study_ L2 - https://doi.org/10.1111/j.1530-0277.2008.00847.x DB - PRIME DP - Unbound Medicine ER -