Osteopenia in alcoholics: effect of alcohol abstinence.
OBJECTIVE
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.


CONCLUSIONS
Ethanol consumption leads to osteopenia, and decreased serum osteocalcin, which improve with abstinence, whereas those who continue drinking show a worsening of both parameters.
Alvisa-Negrín
Julio
J
Hospital Universitario, Universidad de La Laguna, Tenerife, Canary Islands, Spain.
González-Reimers
Emilio
E
Santolaria-Fernández
Francisco
F
García-Valdecasas-Campelo
Elena
E
Valls
M Remedios Alemán
MR
Pelazas-González
Ricardo
R
Durán-Castellón
M Carmen
MC
de Los Angeles Gómez-Rodríguez
María
M
D000428:Alcohol Drinking / Q000453:epidemiology; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology*; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000097:blood / Q000453:epidemiology*; D003720:Densitometry; D005260:Female; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood; D010281:Parathyroid Hormone / Q000097:blood; D015995:Prevalence; D012720:Severity of Illness Index; D013695:Temperance; D014807:Vitamin D / Q000097:blood
D010281:Parathyroid Hormone; D015675:Osteocalcin; D014807:Vitamin D; D007334:Insulin-Like Growth Factor I