Alcohol and Alcoholism Advance Access originally published online on June 17, 2009
Alcohol and Alcoholism 2009 44(5):468-475; doi:10.1093/alcalc/agp038
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Osteopenia in Alcoholics: Effect of Alcohol Abstinence
1 Servicios de Medicina Interna, Hospital Universitario, Universidad de La Laguna, Tenerife, Canary Islands, Spain
2 Servicio de Medicina Nuclear, Hospital Universitario, Universidad de La Laguna, Tenerife, Canary Islands, Spain
* Corresponding author: Servicio de Medicina Interna, Hospital Universitario, Ofra s/n, Tenerife, Canary Islands, Spain. Tel: +34-922-678600; E-mail: egonrey{at}ull.es
Received 9 February 2009; first review notified 17 March 2009; in revised form 27 March 2009, 11 April 2009; accepted 25 May 2009; advance access publication 17 June 2009
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Abstract |
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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.