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Smoking and bone loss among postmenopausal women
Author(s) -
Krall Elizabeth A.,
DawsonHughes Bess
Publication year - 1991
Publication title -
journal of bone and mineral research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.882
H-Index - 241
eISSN - 1523-4681
pISSN - 0884-0431
DOI - 10.1002/jbmr.5650060404
Subject(s) - medicine , femoral neck , bone mineral , menopause , osteoporosis , bone density , calcium , body mass index , calcium metabolism , osteopenia , endocrinology
We examined the effect of smoking on bone mineral density (BMD), rates of bone loss, and fractional whole‐body retention of 47 Ca in healthy postmenopausal women enrolled in a 2‐year calcium supplementation trial. Bone density was measured by single‐ and dual‐photon absorptiometry. BMD of the radius at the study baseline was inversely related to pack‐years of exposure when controlled for body mass index and years since menopause (partial r = ‐0.18, p = 0.05, n = 125). The adjusted mean (±SD) annualized rate of bone change from the radius was greater among smokers than nonsmokers (‐0.914 ± 2.624%/year, n = 34, versus 0.004 ± 2.568%/year, n = 278, respectively; p = 0.05). Similar trends were observed at the femoral neck, os calcis, and spine. Rates were adjusted for caffeine intake, alcohol use, supplement type, and, at the spine only, menopausal status. At entry into the trial higher serum levels of alkaline phosphatase and lower levels of total and ionized calcium were found in smokers compared to nonsmokers. These differences did not persist with supplementation. In 44 women studied fractional 47 Ca retention was lower in the 8 smokers than the 36 nonsmokers (16.6 versus 19.1%, respectively; p = 0.03). These results demonstrate an increased rate of bone loss at the radius after menopause and suggest that smoking is associated with decreased calcium absorption.