BIOCHEMICAL MARKERS OF BONE METABOLISM AFTER SHORT AND LONG-TIME ETHANOL WITHDRAWAL IN ALCOHOLICS

The etiology of ethanol-associated osteopenia is not fully understood, A direct inhibitory effect of ethanol on osteoblast function has been suggested by in vitro and in vivo studies, In this study, we measured biochemical markers for bone formation (osteocalcin, bone specific al kaline phosphatase, procollagen-1-c-terminal peptide) and resorption ( c-terminal telopeptide and urine deoxypyridinoline) in 18 otherwise he althy, but severely alcoholic men during a 10-day period of alcohol wi thdrawal, The same tests were performed in a group of 18 male abstaine rs, with more than 5 years of proven alcohol withdrawal, The results w ere compared with 29 male controls, randomly selected, In the group of alcoholics, osteocalcin (Oc) was significantly decreased at day 1 (p < 0.001; compared with controls), The low serum Oc levels normalized d uring the observation period and no significant difference was seen af ter 10 days, After a 5-year withdrawal, the bone-specific alkaline pho sphatase was increased (p = 0.040) and there was a tendency, but not s ignificant, of a persistent high level of Oc when compared with contro ls, A significant increase in fasting urinary secretion of deoxypyrodi noline was seen among the alcoholics (p = 0.001 compared with controls ), The increase did not normalize during the 10-day observation period , Also, the abstainers had a significantly higher fasting urinary secr etion of deoxypyridinoline after a 5-year alcohol withdrawal (p = 0.02 2 compared with controls), The present study suggests that there is an imbalance between bone formation and bone resorption among alcoholics that could result in rapid bone loss, Although most directions tended to normalize shortly after alcohol withdrawal, biochemical data sugge st that there may still be a persistent high bone turnover after more than 5 years.