Effect of Chronic Alcohol Ingestion on Bone Mineral Density in Males without Liver Cirrhosis

Abstract

Background:Osteoporosis in men is an important public health problem. Because of the tendency of the numbers of the elderly population to increase, and age-specific incidence of fractures, it is inevitable that the health burden due to fractures will increase. Chronic alcoholism is associated with other risk factors, such as poor nutrition, leanness, liver disease, malabsorption, vitamin D deficiency, hypogonadism, hemosiderosis, parathyroid dysfunction and tobacco use, and these may contribute to the pathogenesis of bone disease related to alcoholism. Chronic alcohol intake may reduce bone density, but can also increase bone density. It is well established that liver disease also induces bone density changes, thus it is difficult to distinguish the role of liver disease from that of alcohol itself in the bone alterations occurring in patients with chronic alcohol consumption. Chronic male alcoholics, not having liver cirrhosis were studied to assess the effect of chronic alcohol consumption on their bone mineral density.Methods:The study subjects comprised of 18 chronic heavy drinkers of more than 40 g of alcohol per day for at least 3 years and 18 age-matched controls who drank less than 20 g of alcohol per day. The serum and urinary parameters of bone and mineral metabolism were determined. The 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:The alcoholic and control patients drank an average of 97.6 g and 7.2 g of alcohol per day. Osteocalcin, a marker of bone formation, was slightly decreased in alcoholic patients, and deoxypyridinoline, a marker of bone resorption, was slightly increased, but the difference was not statistically significant (p>0.05).There were no differences between the two groups in the levels of free testosterone, estradiol, 25(OH) vitamin D and parathyroid hormone. The Ward’s triangle and trochanter BMDs of the femur were significantly lower in the alcoholics than the controls, and lumbar spine BMD was decreased in proportion to the total alcohol intake in the alcoholics (r=−0.625, p=0.01).Conclusion:We suggest that chronic alcohol consumption induces low bone density in the femur Ward’s triangle and trochanter. There was also a significant inverse correlation between the lumbar spine BMD and the total amount of alcohol consumed.Large scaled randomized and prospective studies are needed to clarify the pathogenesis of alcohol-induced osteoporosis.

Body Composition Changes in Patients with Chronic Hepatitis C

“…Chronic cholestasis (such as in primary biliary cirrhosis) [7], low levels of insulin-like growth factor-1 [8,9], impairment of J Gastrointestin Liver Dis, September 2016 Vol. 25 No 3: 323-329 receptor activator of nuclear factor κappa B ligand (RANKL) and osteoprotegerin system [10], vitamin D deficiency [11,12], low body mass index (BMI) [13], chronic alcoholism [14] and sedentary lifestyle [15] were implicated in HO pathogenesis. In CHC, the main mechanism seems to be an inflammatory response that increases release of cytokines with bone resorption due to osteoclast activation [16,17].…”

The National Neurosurgery Quality and Outcomes Database Qualified Clinical Data Registry: 2015 measure specifications and rationale

“…101,145 Although few analyses point to a direct association between outcomes of spine care and alcohol consumption, a negative correlation between chronic heavy alcohol consumption and bone mineral density (including that of the spine) has been identified. 70 This evidence indirectly supports the benefit of screening for alcohol use prior to prescribing spine surgery.…”

A study of factors leading to osteo-penia in the community: BMD camp based approach

“…Due to this there is likely to increase in the elderly population and age-specific incidence of fractures, it is inevitable that the health burden due to fractures will increase. 7 Also the female population is at greater risk of osteoporosis. It is also seen that Asian women are at greater risk of osteoporosis.…”

“…This is supported by study conducted by Mi Jin Kim et al, in Korea that osteoporosis in men is an important public health problem. 7 There is neglect of assessing BMD for males as pathophysiology of males relating to osteoporosis remains to be fully elucidated. As methods for the diagnosis of male osteoporosis have not been established.…”

“…As methods for the diagnosis of male osteoporosis have not been established. 7 Also the WHO criteria for females have, until now, been used to diagnose male osteoporosis. In the study it was found that there is a positive correlation of alcohol intake & decreased BMD this is supported by Korean study that stated that chronic alcohol consumption induces low bone density.…”