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Alcohol and bone

  • Factors Affecting Bone Metabolism and Osteoporosis
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Summary

Abuse of alcohol is considered to be an important risk factor for fractures and osteoporosis. Alcohol abuse is associated with deleterious changes in bone structure detected by histomorphometry, and with a decrease in bone mineral density. These changes may also be produced by factors commonly associated with alcohol abuse, e.g., nutritional deficiencies, liver damage, and hypogonadism. Thus the etiology of alcohol-associated bone disease is multifactorial. Alcohol has, however, clear-cut direct effects on bone and mineral metabolism. Acute alcohol intoxication causes transitory hypoparathyroidism with resultant hypocalcemia and hypercalciuria. Prolonged moderate drinking elevates serum parathyroid hormone (PTH) levels, whereas chronic alcoholics are characterized by low serum levels of vitamin D metabolites with resultant malabsorption of calcium, hypocalcemia, and hypocalciuria. Independently of whether alcohol consumption is of short duration, social, or heavy and chronic, it seems to suppress the function of osteoblasts, as evidenced by low serum levels of osteocalcin. It has recently been reported, however, that alcohol can also have a beneficial effect on bone. Among postmenopausal women, moderate alcohol consumption correlates positively with central and peripheral bone mineral density, and with serum estradiol levels.

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References

  1. Seeman E, Melton LJ 3d, O'Fallon WM, Riggs BL (1983) Risk factors for spinal osteoporosis in men. Am J Med 75:977–983

    Article  PubMed  CAS  Google Scholar 

  2. Saville PD (1965) Changes in bone mass with age and alcoholism. J Bone Joint Surg 47:492–499

    PubMed  CAS  Google Scholar 

  3. Rico H (1990) Alcohol and bone disease. Alcohol Alcohol 25:345–352

    PubMed  CAS  Google Scholar 

  4. Verbanck M, Verbanck J, Brauman J, Mullier JP (1977) Bone histology and 25-OH vitamin D plasma levels in alcoholics without cirrhosis. Calcif Tissue Res 22 (Suppl):538–541

    PubMed  Google Scholar 

  5. Johnell O, Nilsson BE, Wiklund PE (1982) Bone morphometry in alcoholics. Clin Orthop 165:253–258

    PubMed  Google Scholar 

  6. DeVernejoul MC, Bielakoff J, Herve M, Gueris J, Hott M, Modrowski D, Kuntz D, Miravet L, Ryckewaert A (1983) Evidence for defective osteoblastic function. A role for alcohol and tobacco consumption in osteoporosis in middle-aged men. Clin Orthop 179:107–115

    Google Scholar 

  7. Bikle DD, Genant HK, Cann C, Recker RR, Halloran BP, Strewler GJ (1985) Bone disease in alcohol abuse. Ann Intern Med 103:42–48

    PubMed  CAS  Google Scholar 

  8. Lalor BC, France MW, Powell D, Adams PH, Counihan TB (1986) Bone and mineral metabolism and chronic alcohol abuse. Q J Med 59:497–511

    PubMed  CAS  Google Scholar 

  9. Feitelberg S, Epstein S, Ismail F, D'Amanda C (1987) Deranged bone mineral metabolism in chronic alcoholism. Metabolism 36:322–326

    Article  PubMed  CAS  Google Scholar 

  10. Rico H, Cabranes JA, Cabello J, Gomez-Castresana F, Hernandez ER (1987) Low serum osteocalcin in acute alcohol intoxication: a direct toxic effect of alcohol on osteoblasts. Bone Miner 2:221–225

    PubMed  CAS  Google Scholar 

  11. Bjørneboe G-EA, Bjørneboe A, Johnsen J, Skylv N, Oftebro H, Gautvik KM, Hoiseth A, Mørland J, Drevon CA (1988) Calcium status and calcium-regulating hormones in alcoholics. Alcoholism 12:229–232

    PubMed  Google Scholar 

  12. Crilly RG, Anderson C, Hogan D, Delaquerriere-Richardson L (1988) Bone histomorphometry, bone mass, and related parameters in alcoholic males. Calcif Tissue Int 43:269–276

    Article  PubMed  CAS  Google Scholar 

  13. Diamond T, Stiel D, Lunzer M, Wilkinson M, Posen S (1989) Ethanol reduces bone formation and may cause osteoporosis. Am J Med 86:282–288

    Article  PubMed  CAS  Google Scholar 

  14. Labib M, Abdel-Kader M, Ranganath L, Teale D, Marks V (1989) Bone disease in chonic alcoholism: the value of plasma osteocalcin measurement. Alcohol Alcohol 24:141–144

    PubMed  CAS  Google Scholar 

  15. Laitinen K, Välimäki M, Lamberg-Allardt C, Kivisaari L, Lalla M, Kärkkäinen M, Ylikahri R (1990) Deranged vitamin D metabolism but normal bone mineral density in Finnish noncirrhotic male alcoholics. Alcoholism 14:551–556

    PubMed  CAS  Google Scholar 

  16. Laitinen K, Lamberg-Allardt C, Tunninen R, Karonen S-L, Tähtelä R, Ylikahri R, Välimäki M (1991) Transient hypoparathyroidism during acute alcohol intoxication. N Engl J Med 324:721–727

    Article  PubMed  CAS  Google Scholar 

  17. Laitinen K, Lamberg-Allardt C, Tunninen R, Karonen S-L, Ylikahri R, Välimäki M (1990) Effects of social drinking on bone mineral metabolism in healthy men. Prevention of Osteoporosis. VII Medical Symposium of the Yrjö Jahnsson Foundation, Porvoo, June 6–8, 1990 (abstract)

  18. Bikle DD (1988) Effects of alcohol abuse on bone. Compr Ther 14:16–20

    PubMed  CAS  Google Scholar 

  19. Kristensson H, Lunden A, Nilsson BE (1980) Fracture incidence and diagnostic roentgen in alcoholics. Acta Orthop Scand 51:205–207

    PubMed  CAS  Google Scholar 

  20. Israel Y, Orrego H, Holt S, Macdonald DW, Meema HE (1980) Identification of alcohol abuse: thoracic fractures on routine X-rays as indicators of alcoholism. Alcoholism 4:420–422

    PubMed  CAS  Google Scholar 

  21. Johnson RD, Davidson S, Saunders JB, Williams R (1984) Fractures on chest radiography as indicators of alcoholism in patients with liver disease. Br Med J 288:365–366

    CAS  Google Scholar 

  22. Johnell O, Kristenson H, Redlund-Johnell I (1985) Lower limb fractures and registration for alcoholism. Scand J Soc Med 13:95–97

    PubMed  CAS  Google Scholar 

  23. Cooper C, Parker DJP, Morris J, Briggs RSJ (1987) Osteoporosis, falls, and age in fracture of the proximal femur. Br Med J 295:13–15

    CAS  Google Scholar 

  24. Peng TC, Garner SC, Frye GD, Crenshaw MA (1982) Evidence of a toxic effect of ethanol on bone in rats. Alcoholism 6:96–99

    PubMed  CAS  Google Scholar 

  25. Peng TC, Kusy RP, Hirsch PF, Hagaman JR (1988) Ethanol-induced changes in morphology and strength of femurs of rats. Alcoholism 12:655–659

    PubMed  CAS  Google Scholar 

  26. Kusy RP, Hirsch PF, Peng T-C (1989) Influence of ethanol on stiffness, toughness, and ductility of femurs of rats. Alcoholism 13:185–189

    PubMed  CAS  Google Scholar 

  27. Saville PD, Lieber CS (1965) Effect of alcohol on growth, bone density and muscle magnesium in the rat. J Nutr 87:477–484

    PubMed  CAS  Google Scholar 

  28. Saville PD, Lieber CS (1969) Increases in skeletal calcium and femur cortex thickness in undernutrition. J Nutr 99:141–144

    PubMed  CAS  Google Scholar 

  29. Turner RT, Greene VS, Bell NH (1987) Demonstration that ethanol inhibits bone matrix synthesis and mineralization in the rat. J Bone Miner Res 2:61–66

    Article  PubMed  CAS  Google Scholar 

  30. Turner RT, Aloia RC, Segel LD, Hannon KS, Bell NH (1988) Chronic alcohol treatment results in disturbed vitamin D metabolism and skeletal abnormalities in rats. Alcoholism 12:159–162

    PubMed  CAS  Google Scholar 

  31. Dalen N, Lamke B (1976) Bone mineral losses in alcoholics. Acta Orthop Scand 47:469–471

    Article  PubMed  CAS  Google Scholar 

  32. Spencer H, Rubio N, Rubio E, Indreika M, Seitam A (1986) Chronic alcoholism. Frequently overlooked cause of osteoporosis in men. Am J Med 80:393–397

    Article  PubMed  CAS  Google Scholar 

  33. Johnell O, Nilsson BE (1984) Bone mineral content in men with fractures of the upper end of the femur. Int Orthop 7:229–231

    Article  PubMed  CAS  Google Scholar 

  34. Harding A, Dunlap J, Cook S, Mattalino A, Azar F, O'Brien M, Kester M (1988) Osteoporotic correlates of alcoholism in young males. Orthopedics 11:279–282

    PubMed  CAS  Google Scholar 

  35. Välimäki M, Salaspuro M, Härkönen M, Ylikahri R (1982) Liver damage and sex hormones in chronic male alcoholics. Clin Endocrinol 17:469–477

    Google Scholar 

  36. Välimäki MJ, Härkönen M, Eriksson CJP, Ylikahri RH (1984) Sec hormones and adrenocortical steroids in men acutely intoxicated with ethanol. Alcohol 1:89–93

    Article  PubMed  Google Scholar 

  37. Välimäki M, Ylikahri RH (1985) Endocrine effects of alcohol. Prog Alcohol Res 1:265–286

    Google Scholar 

  38. Kalbfleisch JM, Lindeman RD, Ginn HE, Smith WO (1963) Effects of ethanol administration on urinary excretion of magnesium and other electrolytes in alcoholic and normal subjects. J Clin Invest 42:1471–1475

    PubMed  CAS  Google Scholar 

  39. Avery DH, Overall JE, Calil HM, Hollister LE (1983) Plasma calcium and phosphate during alcohol intoxication. Alcoholics versus nonalcoholics. J Stud Alcohol 44:205–214

    PubMed  CAS  Google Scholar 

  40. Luisier M, Vodoz JF, Donath A, Courvoisier B, Garcia B (1977) Carence en 25-hydroxyvitamine D avec diminution de l'absorption intestinale de calcium et de la densité osseuse dans l'alcoolisme chronique. Schweiz Med Wochenschr 107:1529–1533

    PubMed  CAS  Google Scholar 

  41. Gascon-Barré M (1985) Influence of chronic ethanol consumption on the metabolism and action of vitamin D. J Am Coll Nutr 4:565–574

    PubMed  Google Scholar 

  42. Bikle DD, Gee E, Halloran B, Haddad JG (1984) Free 1,25 dihydroxyvitamin D levels in serum from normal subjects, pregnant subjects and subjects with liver disease. J Clin Invest 74:1966–1974

    Article  PubMed  CAS  Google Scholar 

  43. Stamp TC, Round JM, Rowe DJ, Haddad JG (1972) Plasma levels and therapeutic effect of 25-hydroxycholecalciferol in epileptic patients taking anticonvulsant drugs. Br Med J 4:9–12

    Article  PubMed  CAS  Google Scholar 

  44. Dechavanne M, Barbier Y, Prost G, Pehlivanian E, Tolot F (1974) Etude de l'absorption du47calcium dans la cirrhose éthylique. Effet du 25 hydroxycholécalciférol. Nouv Presse Med 3:2549–2551

    PubMed  CAS  Google Scholar 

  45. Gavaler JS, Love, K, Ortega Conton T, Galvao-Teles A, Gluud C, Jorgensen S, Monteiro E (1990) An international study of the relationship between alcohol consumption and postmenopausal estradiol. 5th Congress of the International Society for Biomedical Research on Alcoholism, Toronto (abstract)

  46. Hansen MA, Overgaard K, Riis BJ, Christiansen C (1990) Potential risk factors for development of postmenopausal osteoporosis-examined over a 12-year period. Third International Symposium on Osteoporosis, Copenhagen (abstract)

  47. Laitinen K, Välimäki M, Keto P (1991) Bone mineral density measured by dual-energy X-ray absorptiometry in healthy Finnish women. Calcif Tissue Int (in press)

  48. Gordon GG, Southren AL, Vittek J, Lieber CS (1979) The effect of alcohol ingestion on hepatic aromatase activity and plasma steroid hormones in the rat. Metabolism 28:20–24

    Article  PubMed  CAS  Google Scholar 

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Laitinen, K., Välimäki, M. Alcohol and bone. Calcif Tissue Int 49 (Suppl 1), S70–S73 (1991). https://doi.org/10.1007/BF02555094

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