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."
"Low bone mineral density and impaired bone metabolism in young alcoholic patients without liver cirrhosis: a cross-sectional study."
Malik P, et al.
Alcoholism: Clinical and Experimental Research. 33(2), 2009.
Source: Health Behavior News Service
Date originally Published: 1-Dec-08
Date added to Accessibility: 2-Dec-08
Why Binge Drinking Is Bad For Your Bones
Studies in recent years have demonstrated that binge drinking can decrease bone mass and bone strength, increasing the risk of osteoporosis.
Now a Loyola University Stritch School of Medicine study has found a possible mechanism: Alcohol disturbs genes necessary for maintaining healthy bones.
The findings could help in the development of new drugs to minimize bone loss in alcohol abusers. Such drugs also might help people who don't abuse alcohol but are at risk for osteoporosis.
"Of course, the best way to prevent alcohol-induced bone loss is to not drink or to drink moderately," said bone biologist John Callaci, PhD. "But when prevention doesn't work, we need other strategies to limit the damage."
Callaci is co-author of the study, published recently in the journal Alcoholism: Clinical and Experimental Research. He is an assistant professor in Stritch's Department of Orthopaedic Surgery and Rehabilitation.
Callaci's co-authors are Frederick Wezeman, PhD, professor in the Department of Orthopaedic Surgery and Rehabilitation and Ryan Himes, a research assistant in the Burn and Shock Trauma Institute.
The National Osteoporosis Foundation says that many people who abuse alcohol do not get enough calcium. Alcohol also can affect the body's calcium supply. And drinking too much can increase the risk of falls and broken bones. The foundation advises drinking no more than two drinks per day.
Loyola's Alcohol Research Program was among the first centers to demonstrate that rats given an amount of alcohol equivalent to binge drinking show significant decreases in bone mineral density and bone strength. (In humans, binge drinking is defined as a woman having at least four drinks or a man having at least five drinks in two hours.) But surprisingly little was known about the mechanisms responsible for these effects.
In the new study, researchers injected rats with an amount of alcohol equivalent to binge drinking for three days or to chronic alcohol abuse for four weeks. Control groups received injections of saline.
Researchers focused on genes responsible for bone health. They found that alcohol affected the amounts of RNA associated with these genes. (RNA serves as the template for making proteins, the building blocks of bones and other tissue.) With some genes, alcohol increased the amount of RNA. With other genes, alcohol decreased the RNA. Changing the amounts of RNA disrupted two molecular pathways responsible for normal bone metabolism and maintenance of bone mass. These pathways are called the Wnt signaling pathway and the Intergrin signaling pathway.
"We found that the expressions of certain genes important for maintaining bone integrity are disturbed by alcohol exposure," Callaci said.
Loyola scientists and doctors are conducting extensive research on the effects of alcohol. Researchers are, for example, studying how alcohol causes memory loss and impairs the immune system.
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