Association of Alcohol Intake and Fracture Risk in Elderly Varied by Affected Bones: A Nationwide Longitudinal Study

Abstract

Objective Previous studies investigating association of alcohol intake and fracture risk in elderly yielded conflicting results. We first examined the association between alcohol intake and total fracture risk in elderly subjects and further analyzed whether the association varied by fracture locations.Methods This is a nationwide population-based cohort study which included all people aged 66 (n=1,431,539) receiving the National Screening Program during 2009–2014. Time-to-event were defined as duration from study recruitment, the day they received health screening, to the occurrence of fracture.Results Total fracture was significantly lower in mild drinkers [adjusted hazard ratio (aHR)=0.952; 95% confidence interval (95% CI) =0.931–0.973] and higher in heavy drinkers (aHR=1.246; 95% CI=1.201–1.294) than non-drinkers. Risk pattern of alcohol consumption and fracture differed according to affected bones. Similar J-shaped trends were observed for vertebra fractures, but risk of limb fracture showed a linear relationship with alcohol intake. For hip fracture, risk decrement was more pronounced in mild and moderate drinkers, and significant increment was noted only in very severe drinkers [≥60 g/day; (aHR)=1.446; 1.162–1.801].Conclusion Light to moderate drinking generally lowered risk of fractures, but association between alcohol and fracture risk varied depending on the affected bone lesions.

Association of Body Mass Index and Fracture Risk Varied by Affected Bones in Patients with Diabetes: A Nationwide Cohort Study

“…Finally, total fractures included fractures of vertebra, limbs, hip, and others not listed above (i.e., S02.X for skull fracture, S12. X for neck fracture, S62.X for hand, S92.X for foot) [ 23 ].…”

Alcohol Consumption and Risk of Fractures: A Systematic Review and Dose–Response Meta-Analysis of Prospective Cohort Studies

“…Finally, 44 articles (56 studies) were included in the current systematic review. Two of them did not provide sufficient information and lacked quantitative data so were only presented as a systematic review [ 38 , 39 ]; therefore, 42 articles (53 studies) remained in the meta-analysis [ [13] , [14] , [15] , [16] , [17] , [18] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] ] ( Supplemental Figure 1 ).…”

Mechanistic advances in osteoporosis and anti‐osteoporosis therapies

“…24 The effect of alcohol on bone depends on the dosage. Although light (less than 15 g/day) to moderate (less than 30 g/day) drinking generally lowers the risk of fractures, 25 consuming more alcohol will lead to a continuous increase in osteoporotic fracture risk. 26 A prospective study suggests that sarcopenia has a higher risk of developing osteoporosis.…”