Impact of smoking on bone mineral density and bone metabolism in elderly men: the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) study.
Our cross-sectional analysis of 1,576 men aged ≥65 years examined smoking effects on bone status. Number of smoking years was associated with decreased bone mineral density (BMD), after adjusting for age, height, weight, and number of cigarettes smoked daily. Smoking did not affect biochemical marker serum values for bone turnover.


BACKGROUND
The impact of smoking on bone status in men has not been conclusively established. We examined how smoking and its cessation influence bone status and metabolism in men.


METHODS
We analyzed 1,576 men among a baseline survey of Japanese men aged ≥65 years, the Fujiwara-kyo Osteoporosis Risk in Men study, conducted during 2007-2008.


RESULTS
Lumbar spine (LS) BMD values among never, former, and current smokers were 1.045 ± 0.194, 1.030 ± 0.189, and 1.001 ± 0.182 g/cm(2) (P = 0.005), respectively, while total hip (TH) BMD values were 0.888 ± 0.120, 0.885 ± 0.127, and 0.870 ± 0.124 (P = 0.078), respectively. The significant trend for LS BMD remained after adjusting for the covariates; age, height, weight, physical activity, milk consumption, and drinking habit (P = 0.036). Among never and ever (current and former) smokers, LS and TH BMD decreased with the number of pack years or the number of smoking years, respectively, adjusted for those covariates. Among ever smokers, LS and TH BMD decreased with the number of smoking years after adjusting for age, height, weight, and number of cigarettes smoked daily. Smoking did not reveal significant effect for serum osteocalcin or tartrate resistant acid phosphatase isoenzyme 5b.


CONCLUSIONS
The impact of smoking on bone status is mainly associated with the number of smoking years in elderly men.
Tamaki
J
J
Department of Public Health, Kinki University School of Medicine, 377-2, Oono-higasi, Osaka-sayama, Osaka, 589-8511, Japan.
Iki
M
M
Fujita
Y
Y
Kouda
K
K
Yura
A
A
Kadowaki
E
E
Sato
Y
Y
Moon
J S
JS
Tomioka
K
K
Okamoto
N
N
Kurumatani
N
N
D000135:Acid Phosphatase / Q000097:blood; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000502:physiology*; D001842:Bone and Bones / Q000378:metabolism*; D003430:Cross-Sectional Studies; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D007527:Isoenzymes / Q000097:blood; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008297:Male; D015675:Osteocalcin / Q000097:blood; D010024:Osteoporosis / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology; D012907:Smoking / Q000009:adverse effects / Q000378:metabolism / Q000503:physiopathology*; D016540:Smoking Cessation; D000071681:Tartrate-Resistant Acid Phosphatase
D015415:Biomarkers; D007527:Isoenzymes; D015675:Osteocalcin; D000135:Acid Phosphatase; D000071681:Tartrate-Resistant Acid Phosphatase
J Bone Miner Res. 1997 Sep;12(9):1495-501
9286767
BMJ. 1997 Oct 4;315(7112):841-6
9353503
J Clin Densitom. 2008 Oct-Dec;11(4):518-24
18789741
Osteoporos Int. 2001;12(7):529-37
11527049
Calcif Tissue Int. 1997 Jun;60(6):496-500
9164822
J Bone Miner Metab. 2008;26(3):265-70
18470668
Osteoporos Int. 2007 Aug;18(8):1033-46
17323110
Aging (Milano). 1993 Feb;5(1):55-62
8481426
J Bone Miner Res. 1995 Nov;10(11):1769-77
8592955
Eur J Endocrinol. 2008 Mar;158(3):401-9
18299475
Calcif Tissue Int. 2001 Oct;69(4):229-34
11730257
Osteoporos Int. 2005 Feb;16(2):155-62
15175845
J Clin Endocrinol Metab. 2002 Feb;87(2):666-74
11836302
Osteoporos Int. 1992 Nov;2(6):285-9
1421796
J Musculoskelet Neuronal Interact. 2006 Jul-Sep;6(3):234-41
17142943
J Clin Endocrinol Metab. 1992 Oct;75(4):1060-5
1400871
J Bone Miner Res. 1995 May;10(5):782-7
7639113
Med Sci Sports Exerc. 2003 Aug;35(8):1381-95
12900694
Osteoporos Int. 2006 Feb;17(2):297-303
16175311
Clin Lab. 2006;52(9-10):499-509
17078477
J Bone Miner Res. 1994 Sep;9(9):1339-46
7817817
J Epidemiol Community Health. 1996 Feb;50(1):47-50
8762353
BMC Musculoskelet Disord. 2009 Dec 24;10:165
20030855
CMAJ. 1992 Nov 15;147(10):1477-88
1423088
Calcif Tissue Int. 2001 May;68(5):259-70
11683532
Osteoporos Int. 1996;6(3):240-8
8783299
Clin Sci (Lond). 2007 Sep;113(5):233-41
17663660
Eur J Clin Invest. 1992 Jul;22(7):454-60
1516592
Age Ageing. 1992 Jan;21(1):20-6
1553855
J Clin Endocrinol Metab. 2007 Feb;92(2):428-9
17284647
Osteoporos Int. 2004 Apr;15(4):263-73
14985946