Lifetime and recent alcohol use and bone mineral density in adults with HIV infection and substance dependence

Ventura, Alicia S.; Winter, Michael; Heeren, Timothy; Sullivan, Meg; Walley, Alexander Y.; Holick, Michael F.; Patts, Gregory; Meli, Seville; Samet, Jeffrey H.; Saitz, Richard

doi:10.1097/md.0000000000006759

Cited by 13 publications

(16 citation statements)

References 76 publications

(84 reference statements)

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“…The current study results are also are in line with previous studies using the same cohort on the impact of alcohol on bone density which found that alcohol consumption was associated with lower bone density at baseline (Ventura et al, ). However, a change in alcohol consumption was not prospectively associated with change in bone density (Saitz et al, ).…”

Section: Discussionsupporting

confidence: 93%

“…The metabolic effects of the systemic inflammatory reaction and oxidative stress induced by alcohol are widespread and include muscle wasting and lipoatrophy (Bagby et al, ; Gaddini et al, ; Molina et al, ). Although heavy alcohol consumption is associated with fracture (Kanis et al, ; Zhang et al, ), the effects of alcohol on bone mineral density (Gaddini et al, ) are unclear, particularly in PLWH (Brown et al, ; Saitz et al, ; Sharma et al, ; Ventura et al, ).…”

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confidence: 99%

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Alcohol and Bone Turnover Markers among People Living with HIV and Substance Use Disorder

Kim

Ventura

Winter

et al. 2020

Alcoholism Clin & Exp Res

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Background: Although unhealthy alcohol use and low bone density are prevalent among people living with HIV (PLWH), it is not clear whether alcohol use is associated with bone turnover markers (BTMs), and if so, at what quantity and frequency. The study objective was to examine the association between alcohol and BTMs in PLWH with substance use disorder.Methods: We studied a prospective cohort recruited from 2 HIV clinics who met criteria for DSM-IV substance dependence or reported ever injection drug use. Outcomes were BTM of (i) bone formation (serum procollagen type 1 N-terminal propeptide [P1NP]) and (ii) bone resorption (serum Ctelopeptide type 1 collagen [CTx]). Alcohol consumption measures included (i) mean number of drinks/ d (Timeline Follow-Back [TLFB]) (primary predictor), (ii) any alcohol use on ≥20 of the past 30 days, and phosphatidylethanol (PEth), a biomarker of recent alcohol consumption. Linear regression analysis examined associations between (i) each alcohol measure and each BTM and (ii) change in alcohol and change in BTM over 12 months.Results: Among 198 participants, baseline characteristics were as follows: The median age was 50 years; 38% were female; 93% were prescribed antiretroviral medications; 13% had ≥20 drinking days/month; mean drinks/day was 1.93 (SD 3.89); change in mean drinks/day was À0.42 (SD 4.18); mean P1NP was 73.1 ng/ml (SD 34.5); and mean CTx was 0.36 ng/ml (SD 0.34). Higher drinks/day was significantly associated with lower P1NP (slope À1.09 ng/ml; 95% confidence interval [CI] À1.94, À0.23, per each additional drink). On average, those who drank on ≥ 20 days/month had lower P1NP (À15.45 ng/ml; 95% CI: À26.23, À4.67) than those who did not. Similarly, PEth level ≥ 8ng/ml was associated with lower P1NP. An increase in drinks/d was associated with a decrease in P1NP nonsignificantly (À1.14; 95% CI: À2.40, +0.12; p = 0.08, per each additional drink). No significant associations were detected between either alcohol measure and CTx.Conclusions: In this sample of PLWH with substance use disorder, greater alcohol consumption was associated with lower serum levels of bone formation markers.

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Section: Discussionsupporting

confidence: 93%

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confidence: 99%

Alcohol and Bone Turnover Markers among People Living with HIV and Substance Use Disorder

Kim

Ventura

Winter

et al. 2020

Alcoholism Clin & Exp Res

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“…In the same cohort, Ventura et al. () reported a cross‐sectional, negative association between BMD and recent alcohol consumption, with the strongest association during the postdiagnosis/pre‐ART phase of the HIV care continuum. We did not examine alcohol consumption during different phases (i.e., pre‐HIV, pre‐ART, post‐ART).…”

Section: Discussionmentioning

confidence: 95%

“…Although PEth (which is most effective as a very recent measure of consumption) can help validate these responses, by selecting subjects with high recent drinking levels we may be selecting participants with greater recall bias toward higher AUDIT responses. Subjects were not excluded based on concurrent recreational drug use, which has been considered a confounder in similar analyses (Saitz et al., ; Ventura et al., ). Thus, additional factors related to adverse health effects (with the exception of smoking) have not been fully characterized in this analysis.…”

Section: Discussionmentioning

confidence: 99%

Reduced Serum Osteocalcin in High‐Risk Alcohol Using People Living With HIV Does Not Correlate With Systemic Oxidative Stress or Inflammation: Data From the New Orleans Alcohol Use in HIV Study

Watt

Schuon

Davis

et al. 2019

Alcoholism Clin & Exp Res

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Background: HIV infection is now largely a chronic condition as a result of the success of antiretroviral therapy. However, several comorbidities have emerged in people living with HIV (PLWH), including alcohol use disorders and musculoskeletal disorders. Alcohol use has been associated with lower bone mineral density, alterations to circulating bone turnover markers, and hypocalcemia. The pathophysiological basis of bone loss in the PLWH population is unclear but has been suggested to be linked to oxidative stress and inflammation. To test the hypothesis that PLWH consuming excessive alcohol have altered markers of bone turnover and/or calcium homeostasis in association with oxidative stress, we correlated measurements of alcohol consumption with markers of oxidative stress and inflammation, serum calcium concentrations, and measurements of bone turnover, including c-terminal telopeptide cross-links (CTX-1) and osteocalcin.Methods: Data were drawn from cross-sectional baseline data from the ongoing New Orleans Alcohol Use in HIV (NOAH) study, comprised of 365 in care PLWH. Alcohol consumption measures (Alcohol Use Disorders Test, 30-day timeline follow-back calendar, and phosphatidylethanol [PEth]) were measured in a subcohort of 40 subjects selected based on highest and lowest PEth measurements. Multivariate linear regression was performed to test the relationships between alcohol consumption and systemic oxidative stress (4-hydroxynonenal; 4-HNE) and inflammation (c-reactive protein; CRP).Results: Serum calcium and CTX-1 did not differ significantly between the high and low-PEth groups. Individuals in the high-PEth group had significantly lower serum osteocalcin (median low-PEth group: 13.42 ng/ml, inter-quartile range [IQR] 9.26 to 14.99 ng/ml; median high-PEth group 7.39 ng/ ml, IQR 5.02 to 11.25 ng/ml; p = 0.0005, Wilcoxon rank-sum test). Osteocalcin negatively correlated with PEth (Spearman r = À0.45, p = 0.05) and self-reported measures after adjusting for covariates. Alcohol consumption showed mild, but significant, positive associations with serum 4-HNE, but not with CRP. Osteocalcin did not correlate with either 4-HNE or CRP.Conclusions: In this subcohort of PLWH, we detected significant associations between at-risk alcohol use and osteocalcin, and at-risk alcohol use and serum 4-HNE, suggesting suppression of bone formation independent of increased systemic oxidative stress with increasing alcohol consumption.

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“…Alcohol consumption causes harmful effects on bone density [7] and is related to osteoporosis, due to imbalance in bone repair [8], altering bone microarchitecture, decreasing trabecular and cortical bone thickness, and consequently increasing the risk of fracture [9].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Use of an Inorganic Bone Matrix in the Repair of Bone Defects in Rats Submitted to Experimental Alcoholism

et al. 2020

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To assess the effects of chronic alcoholism on the repair of bone defects associated with xenograft. Forty male rats were distributed in: control group (CG, n = 20) and experimental group (EG, n = 20), which received 25% ethanol ad libitum after a period of adaptation. After 90 days of liquid diet, the rats were submitted to 5.0-mm bilateral craniotomy on the parietal bones, subdividing into groups: CCG (control group that received only water with liquid diet and the defect was filled with blood clot), BCG (control group that received only water with liquid diet and the defect was filled with biomaterial), CEG (alcoholic group that received only ethanol solution 25% v/v with liquid diet and the defect was filled with blood clot), and BEG (alcoholic group that received only ethanol solution 25% v/v with liquid diet and the defect was filled with biomaterial). In the analysis of body mass, the drunk animals presented the lowest averages in relation to non-drunk animals during the experimental period. Histomorphologically all groups presented bone formation restricted to the defect margins at 60 days, with bone islets adjacent to the BCG biomaterial particles. CEG showed significant difference compared to BEG only at 40 days (17.42 ± 2.78 vs. 9.59 ± 4.59, respectively). In the birefringence analysis, in early periods all groups showed red-orange birefringence turning greenish-yellow at the end of the experiment. The results provided that, regardless of clinical condition, i.e., alcoholic or non-alcoholic, in the final period of the experiment, the process of bone defect recomposition was similar with the use of xenograft or only clot.

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Lifetime and recent alcohol use and bone mineral density in adults with HIV infection and substance dependence

Abstract: Supplemental Digital Content is available in the text

Cited by 13 publications

References 76 publications

Alcohol and Bone Turnover Markers among People Living with HIV and Substance Use Disorder

Alcohol and Bone Turnover Markers among People Living with HIV and Substance Use Disorder

Reduced Serum Osteocalcin in High‐Risk Alcohol Using People Living With HIV Does Not Correlate With Systemic Oxidative Stress or Inflammation: Data From the New Orleans Alcohol Use in HIV Study

Evaluation of the Use of an Inorganic Bone Matrix in the Repair of Bone Defects in Rats Submitted to Experimental Alcoholism

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