Clinical Aspects: Osteopenia in Alcoholics: Effect of Alcohol Abstinence

• Published in: Alcohol and alcoholism (Oxford) Vol. 44; no. 5; pp. 468 - 475
• Main Authors: Alvisa-Negrin, Julio, Gonzalez-Reimers, Emilio, Santolaria-Fernandez, Francisco, Garcia-Valdecasas-Campelo, Elena, Valls, M. Remedios Aleman, Pelazas-Gonzalez, Ricardo, Duran-Castellon, M Carmen, de los Angeles Gomez-Rodriguez, Maria
• Format: Journal Article
• Language: English
• Published: 01.09.2009
• Subjects: Abstinence; Alcoholics; Bone mineral density; Osteopenia; Parameters; Serum
• ISSN: 0735-0414
• DOI: 10.1093/alcalc/agp038

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 < 0.00 ), lower IGF-1 [median = 49, interquartile range (IQR) = 31-121 ng/ml versus 135, IQR = 116-237 ng/ml, P < 0.001], vitamin B [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. Adapted from the source document.