Osteopenia in alcoholics: Effect of alcohol abstinence

Abstract

Aims: 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. Conclusion: Ethanol consumption leads to osteopenia, and decreased serum osteocalcin, which improve with abstinence, whereas those who continue drinking show a worsening of both parameters. © The Author 2009. Published by Oxford University Press on behalf of the Medical Council on Alcohol. All rights reserved.