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Bone mass improves in alcoholics after 2 years of abstinence
Author(s) -
Peris Pilar,
Parés Albert,
Guan̄abens Núria,
Del Río Luis,
Pons Francesca,
De Osaba Maria Jesús Martínez,
Monegal Ana,
Caballería Joan,
Rodés Joan,
MuñozGómez José
Publication year - 1994
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.5650091014
Subject(s) - medicine , osteocalcin , bone mineral , femoral neck , abstinence , endocrinology , osteoporosis , bone remodeling , bone density , vitamin d and neurology , parathyroid hormone , urology , calcium , alkaline phosphatase , chemistry , biochemistry , psychiatry , enzyme
To evaluate the effect of abstinence on bone mass and bone mineral metabolism in chronic alcoholics, a 2 year longitudinal follow‐up study was carried out in a group of 30 chronic alcoholic males who started a rehabilitation program. Lumbar and femoral bone mineral density (BMD) and serum levels of osteocalcin and 25‐hydroxyvitamin D were measured at entry and after 1 and 2 years in all patients. Circulating cortisol and parathyroid hormone were measured in 14 and 6 patients, respectively, at entry and every year. Testosterone was measured in 18 patients at entry and after 1 year. At entry, lumbar BMD was significantly lower in alcoholics (1.06 + 0.03 g/cm 2 ) than in age‐matched healthy men (1.22 + 0.03 g/cm 2 ; p < 0.001). Circulating osteocalcin and vitamin D levels were also significantly lower in alcoholics than in controls. Lumbar and femoral neck BMD increased in alcoholics after 2 years of abstinence (lumbar BMD, mean + SEM, 1.06 + 0.03 to 1.10 + 0.04 g/cm 2 , p < 0.05; femoral BMD, 0.82 + 0.02 to 0.84 + 0.02 g/cm 2 ; p < 0.02). Moreover, lumbar BMD increased in alcoholics (2.9 + 1.4%) and decreased in controls (–1.1 + 0.2%; p < 0.02). Femoral BMD also increased in alcoholics (2.8 + 1.0%) but the expected mean decrease of –0.92% was found in healthy age‐matched males. Baseline low osteocalcin levels (5.1 + 0.6 ng/ml) increased after 1 year (8.6 + 0.5 ng/ml, p < 0.001) and 2 years of abstinence (9.5 + 0.7 ng/ml, p < 0.001). No significant changes in 25‐hydroxyvitamin D, parathyroid hormone, testosterone, or cortisol levels were observed throughout the study. Presence and severity of liver disease did not correlate with bone mass changes. We conclude that in chronic alcoholics lumbar and femoral neck bone mass improves after abstinence. The increase in circulating osteocalcin without associated changes in other circulating hormones further supports the hypothesis that alcohol has deleterious effects on bone formation.