Impaired skeletal health and neuromuscular function among amphetamine users in clinical treatment.
CONCLUSIONS
This study examined musculoskeletal health in amphetamine users, compared with healthy age-matched controls. We show that amphetamine users have reduced bone mass at several skeletal sites and attenuated maximal muscle strength and force development capacity in the lower extremities.


BACKGROUND
Amphetamine use may cause poor bone quality and elevated risk of osteoporosis. The purpose of this study was to investigate whether amphetamine users exhibit reduced regional and whole body bone mineral density (BMD), altered bone metabolism, and how muscle function may relate to the patient groups' skeletal health.


METHODS
We assessed hip, lumbar spine and whole body BMD, and trabecular bone score (TBS) by dual x-ray absorptiometry (DXA), and bone metabolism markers in serum and maximal strength and force development capacity in 36 amphetamine users (25 men, 30 ± 7 years; 11 women 35 ± 10 years) and in 37 healthy controls (23 men, 31 ± 9 years; 14 women, 35 ± 7 years).


RESULTS
Whole body BMD was lower in amphetamine users (8% in males and 7% females, p < 0.01), as were BMD at the total hip and sub-regions of the hip (9-11% in men and 10-11 % in women, p < 0.05). Male users had 4% lower TBS (p < 0.05) and higher serum level of type 1 collagen amino-terminal propeptide (p < 0.01). This coincided with reduced lower extremity maximal strength of 30% (males, p < 0.001) and 25% (females, p < 0.05) and 27% slower muscular force development in males compared to controls (p < 0.01).


CONCLUSIONS
These findings demonstrate that amphetamine users suffer from a generalized reduction in bone mass, which was associated with attenuated maximal muscle strength and force development capacity in the lower extremities.
Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway. mats.p.mosti@ntnu.no.
M P
MP
Mosti
Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olav's University Hospital, Trondheim, Norway.
G
G
Flemmen
Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Physical Medicine and Rehabilitation, St. Olav's University Hospital, Trondheim, Norway.
J
J
Hoff
Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
A K
AK
Stunes
Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Endocrinology, St. Olav's University Hospital, Trondheim, Norway.
U
U
Syversen
Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA.
E
E
Wang
D015502:Absorptiometry, Photon / Q000379:methods; D000328:Adult; D019969:Amphetamine-Related Disorders / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D000662:Amphetamines / Q000494:pharmacology; D000886:Anthropometry / Q000379:methods; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000187:drug effects / Q000502:physiology; D001842:Bone and Bones / Q000378:metabolism; D000071556:Cancellous Bone / Q000187:drug effects / Q000503:physiopathology; D016022:Case-Control Studies; D005260:Female; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000187:drug effects / Q000502:physiology; D010024:Osteoporosis / Q000097:blood / Q000139:chemically induced* / Q000503:physiopathology
D000662:Amphetamines; D015415:Biomarkers
Addiction; Body composition; One repetition maximum; Physical capacity; Rate of force development; Rehabilitation