Osteopenia in Alcoholics: Effect of Alcohol Abstinence.
Alvisa-Negrin, Julio 1; Gonzalez-Reimers, Emilio 1,*; Santolaria-Fernandez, Francisco 1; Garcia-Valdecasas-Campelo, Elena 1; Valls, M Remedios Aleman 1; Pelazas-Gonzalez, Ricardo 1; Duran-Castellon, M Carmen 1; de los Angeles Gomez-Rodriguez, Maria 2
[Miscellaneous Article]
Alcohol & Alcoholism.
44(5):468-475, September/October 2009.
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Aims: The aims of this study were to assess bone mineral density (BMD) and content (BMC), osteocalcin, serum telopeptide, PTH and vitamin D in alcoholics, and to determine if a 6-month period of abstinence leads to changes in these parameters.
Methods: Serum osteocalcin, insulin-like growth factor 1 (IGF-1), telopeptide (40 patients) and 1,25 dihydroxyvitamin D, were measured in 28 controls and 77 alcoholic patients, 48 of whom were evaluated again 6 months later. All patients underwent whole-body assessment of BMD by a Hologic QDR-2000 (Waltham, MA, USA) bone densitometer, at the beginning of the study and 6 months later.
Results: Patients showed higher serum telopeptide levels (0.59 /- 0.40 versus 0.19 /- 0.10 nmol/100 ml, P < 0.001), lower IGF-1 [median=49, interquartile range (IQR)=31-121 ng/ml versus 135, IQR=116-237 ng/ml, P < 0.001], vitamin D [26.5, IQR=17.0-37.8 pg/ml versus 82.4 (IQR=60.9-107.4 pg/ml, P < 0.001] and osteocalcin (2.1, IQR=1.1-3.6 ng/ml versus 6.65, IQR=4.9-8.8 ng/ml, P < 0.001) than those in controls. Patients also showed lower BMD values, Z- and T-scores at many levels of the skeleton and reduced total BMC. After 6 months, those who continued drinking showed a loss of bone mass, whereas those who abstained showed either no change or increase, differences being especially marked at pelvis, right arm and total BMD and BMC. Simultaneously, abstainers showed a significant increase in osteocalcin (versus a decrease among those who continued drinking). Serum telopeptide increased in both groups.
Conclusion: Ethanol consumption leads to osteopenia, and decreased serum osteocalcin, which improve with abstinence, whereas those who continue drinking show a worsening of both parameters.
(C) Medical Council on Alcohol 2009. Published by Oxford University Press. All rights reserved.