Little is known about thè effects of chronic alcohol abuse on minerai metab-olism (Ca, P, Mg) and on thè prevalence of fraetures in alcoholies. In a series of 37 male chronic alcoholies (age, 38.0 ± 7.1 years, body mass index 25.2 ± 3.1, years of alcohol abuse 16.1 ± 7.0) lumbar and femoral bone min-erai density (BMD), vertebra! morphometry (MXA), and dual X-ray absorp-tiometry (DXA) were assessed, as well as thè levels of Ca, P, Mg, 25(OH) vitamin D, parathyroid hormone (PTH), and semm C-terminal telopeptide of type I collagen ((3-CTx). The diagnosis of chronic alcoholism was established according to DSM-IV. Only subjects in thè early stage of alcohol liver disease, affected by liver steatosis and/or by mild alcobolic hepatitis, were included in thè study. Subjects affected by liver cirrhosis were excluded, as well as sub¬jects bedridden or affected by bone diseases, minerai metabolism diseases, or severe malnutritìon. Informed consent was obtained by ali thè subjects on study. In our series, bone fraetures were found in 29 patients (62%). A history of tight trauma was reported in 18 patients, whìle 11 had vertebra! factures, demonstrated by MXA (15%) or by thè assessment of thè difference between thè posterior and thè anterior vertebral height (thè difference should be <4 mm). However, only five of thè patients with vertebral fraetures (17%) had BMD below thè fracture threshold. An inverse correlatìon between years of alcohol abuse and serum p-CTx (/'<0.01), T-score of lumbar spine (P < 0.01), and femoral BMD (P < 0.01) was found. In conclusion, highpreva-lenee of bone fracture was found in male chronic alcoholies with early-stage alcoholic liver disease. As bone fraetures seem unrelated to BMD decrease, chronic alcohol abuse seems to be an independent risk factor of bone fraetures, affectìng thè quality of bone. A pathogenetic factor could be thè inductìon of thè cytochrome P450 System, common in chronic alcohol abusers, which is an established factor of derangement of vitamin D metabolism. Indeed, thè inverse coirelatìon between alcohol consumption and bone resumption suggests thè development of an alcohol-indueed low turnover osteoporosis.

Bone minerai, metabolìsm and prevalence of Fractures in male alcoholics / Attilia, Maria Luisa; Paglia, F; Minisola, Salvatore; Santoli, C; Prastaro, A; Nocente, R; Rotondo, Claudia; Romagnoli, Emilio; Toppo, L; Ceccanti, Mauro. - In: ALCOHOL AND ALCOHOLISM. - ISSN 0735-0414. - STAMPA. - (2005). (Intervento presentato al convegno ESBRA 2005 tenutosi a Canterbury nel 04-07-september).

Bone minerai, metabolìsm and prevalence of Fractures in male alcoholics

ATTILIA, Maria Luisa;MINISOLA, Salvatore;ROTONDO, CLAUDIA;ROMAGNOLI, Emilio;CECCANTI, Mauro
2005

Abstract

Little is known about thè effects of chronic alcohol abuse on minerai metab-olism (Ca, P, Mg) and on thè prevalence of fraetures in alcoholies. In a series of 37 male chronic alcoholies (age, 38.0 ± 7.1 years, body mass index 25.2 ± 3.1, years of alcohol abuse 16.1 ± 7.0) lumbar and femoral bone min-erai density (BMD), vertebra! morphometry (MXA), and dual X-ray absorp-tiometry (DXA) were assessed, as well as thè levels of Ca, P, Mg, 25(OH) vitamin D, parathyroid hormone (PTH), and semm C-terminal telopeptide of type I collagen ((3-CTx). The diagnosis of chronic alcoholism was established according to DSM-IV. Only subjects in thè early stage of alcohol liver disease, affected by liver steatosis and/or by mild alcobolic hepatitis, were included in thè study. Subjects affected by liver cirrhosis were excluded, as well as sub¬jects bedridden or affected by bone diseases, minerai metabolism diseases, or severe malnutritìon. Informed consent was obtained by ali thè subjects on study. In our series, bone fraetures were found in 29 patients (62%). A history of tight trauma was reported in 18 patients, whìle 11 had vertebra! factures, demonstrated by MXA (15%) or by thè assessment of thè difference between thè posterior and thè anterior vertebral height (thè difference should be <4 mm). However, only five of thè patients with vertebral fraetures (17%) had BMD below thè fracture threshold. An inverse correlatìon between years of alcohol abuse and serum p-CTx (/'<0.01), T-score of lumbar spine (P < 0.01), and femoral BMD (P < 0.01) was found. In conclusion, highpreva-lenee of bone fracture was found in male chronic alcoholies with early-stage alcoholic liver disease. As bone fraetures seem unrelated to BMD decrease, chronic alcohol abuse seems to be an independent risk factor of bone fraetures, affectìng thè quality of bone. A pathogenetic factor could be thè inductìon of thè cytochrome P450 System, common in chronic alcohol abusers, which is an established factor of derangement of vitamin D metabolism. Indeed, thè inverse coirelatìon between alcohol consumption and bone resumption suggests thè development of an alcohol-indueed low turnover osteoporosis.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/420722
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