MINERAL METABOLISM, OSTEOBLASTIC FUNCTION AND BONE MASS IN CHRONIC-ALCOHOLISM

The role of ethanol as a risk factor for osteopenia was studied in alc oholic subjects without liver cirrhosis. The study was carried out in 58 male subjects classified into three groups: (1) 26 heavy drinkers, alcohol intake more than 100 g ethanol/day for more than 10 years; (2) 13 moderate drinkers, 60-100 g ethanol/day; (3) 19 healthy non-drinke rs who served as control subjects. None of the drinkers had liver cirr hosis (normal clinical and biochemical data and/or liver biopsy). Mine ral metabolism and serum bone Gla-protein (BGP) were studied while the y were active drinkers and after they had abstained from ethanol for 7 days. Bone mineral density (BMD) was determined at the beginning of t he study. Osteopenia was observed in 23% of the heavy drinkers. We fou nd a significant inverse correlation between BMD and an index of cumul ative alcohol intake. Heavy and moderate drinkers had significantly lo wer mean BGP values (1.6 +/- 0.4 and 1.9 +/- 0.3 ng/ml) (P < 0.01 for both) than controls (3.5 +/- 0.4 ng/ml); these values increased signif icantly (2.9 +/- 0.4 ng/ml; P < 0.01) after 7 days of abstinence. The data show that chronic ethanol ingestion can induce osteopenia regardl ess of the absence of liver cirrhosis, and that some relationship can be expected between the amount and duration of ethanol consumption and the degree of bone loss. The low serum BGP levels in drinkers are rev ersible upon withdrawal of ethanol, suggesting that reduction of osteo blastic activity is probably the main factor responsible for alcohol-a ssociated bone disease.