Effect of chronic alcohol ingestion on bone mineral density in males without liver cirrhosis

Kim, Mi Jin; Shim, Myung Suk; Kim, Moon Kyu; Lee, Yeon; Koh, Jang Hyun; Shin, Young Goo; Chung, Choon Hee; Kwon, Sang Ok

Abstract

BACKGROUND: Osteoporosis in men is an important public health problem. Because of the incremental tendency of elderly population and age-specific incidence of fracture, it is inevitable that the health burden of fracture will increase. Also, the mortality of fracture in men is higher than in women. Alcohol consumption is a risk factor for osteoporosis based on the frequent finding of a low bone mass decreased bone formation rate and increased fracture incidence in alcoholics. Chronic alcohol consumption may reduce bone density but also increase bone density. It has been well established that liver cirrhosis also induces bone density changes and thus it is difficult to distinguish the role of liver disease from that of alcohol itself in bone alterations occurring in patients with chronic alcohol consumption. So we studied male chronic alcoholics which did not have liver cirrhosis to assess the effect of chronic alcohol consumption on bone mineral density.
METHODS
We studied 18 chronic heavy drinkers of more than 40 g/day for at least 5 years and age-matched 18 control groups who had drunk alcohol less than 20 g/day. Serum and urinary parameters of bone and mineral metabolism were determined. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry at four axial sites (lumbar spine, femoral neck, ward's triangle and trochanter).
RESULTS
Alcoholic patients drank alcohol 97.7 g/day. Osteocalcin, a marker of bone formation, was slight decreased in alcoholic patients and deoxypyridinoline, a marker of bone resorption, was slight increased but not statistically significant (p > 0.05). The levels of 25-(OH)-vit D, parathyroid hormone, free testosterone, estradiol were not different between the two groups. Ward's triangle and trochanter BMD of femur were significantly lower than controls and L-spine BMD decreased parallel with total alcohol intake amount in the alcoholics (r=-0.62, p < 0.05).
CONCLUSION
We suggest that chronic alcohol consumption induced low bone density on femur ward and trochanter. And there was significant inverse correlation between L-spine BMD and total alcohol consumption amount. The large scaled randomized and prospective studies are needed to clarify the pathogenesis of alcohol-induced male osteoporosis.