Younger Alcoholic Men At Risk For Osteoporosis
Low bone mass, or osteoporosis, is a known consequence of alcoholism, especially in older alcoholics. However, a new study shows that younger male alcoholics are also at increased risk for osteoporosis. People with osteoporosis, no matter what the cause, are at an increased risk for fractures and poor fracture healing.
"Our study indicates malnutrition, little exercise, social withdrawal or little exposure to sunlight can contribute to osteoporosis in young alcohol-dependent patients," said lead investigator Peter Malik, M.D., of the Medical University at Innsbruck, Austria.
The study appears online and in the February 2009 issue of the journal Alcoholism: Clinical and Experimental Research.
Researchers measured the bone mineral density of 37 alcoholic men and 20 alcoholic women ages 27 to 50. All participants were currently inpatients of an alcohol rehabilitation clinic and were not drinking at the time of the examination. Patients with liver cirrhosis or those taking medications known to influence bone health were not included in the study.
Before entering rehabilitation, the men consumed an average of 22 drinks per day and the women consumed an average of 18 drinks per day. Most of the participants smoked.
Almost one-quarter of the men had a bone mineral density that was lower than expected for age. In the women's group, only 5 percent (1 person) had a low bone mineral density.
"It was surprising to me that although the female patients consumed high amounts of alcohol, there seems to be a protective factor present — probably higher estrogen levels — which cannot be fully explained at the moment," Malik said.
Most of the participants also had low vitamin D levels, likely an indication of poor nutrition and lack of exposure to sunlight. Low vitamin D levels can lead to osteoporosis, but the researchers found no direct relationship to vitamin D levels and decreased bone mineral density.
"One of the significant aspects of Dr. Malik's paper is that there are very few studies that have looked at osteoporosis in this particular [younger] age group of alcoholics," said U.S. researcher Dennis Chakkalakal, Ph.D.
Osteocalcin, a laboratory marker for new bone formation, was above the normal range in about 38 percent of men and 30 percent of women. This suggests that osteoporosis is at least partially reversible in alcoholics who quit drinking, as these patients did.
"It has been demonstrated very clearly that more than 30 days of abstinence results in increasing osteocalcin," said Chakkalakal, of the Orthopedic Research Laboratory and Alcohol Research Center at the Omaha Veterans Affairs Medical Center.
Malik said that the results of his study and other research indicate a need to screen alcoholic men for osteoporosis. "Medical therapy for osteoporosis, when started early, can improve the long-term outcome."