MECHANISMS OF HYPOCALCEMIA AND MARKERS OF BONE TURNOVER IN ALCOHOL-INTOXICATED DRINKERS

Studies of hypocalcemia and osteoporosis frequently encountered in hea vy users of alcohol have previously been performed on alcoholic people who have already recovered from alcohol intoxication. Bone and minera l metabolism during and after the intoxication may be different. We me asured serum parameters of bone and mineral metabolism in 26 alcohol-i ntoxicated men and in 19 healthy control men. Although serum ionized c alcium was 12% (P < 0.0001) lower in the patients than in the controls , serum intact parathyroid hormone was similar in the study groups. As reflected by decreased serum levels of osteocalcin (-43%; P < 0.001), bone formation was depressed in the patients. Serum cross-linked carb oxyterminal telopeptide of human type I collagen (ICTP), a novel param eter of bone matrix degradation, was 9% higher in the patients (P = 0. 03) than controls. The positive correlation between serum osteocalcin and ICTP in the controls (r = 0.59, P < 0.01) was absent in the patien ts (r = 0.05, P = 0.8). We conclude that in alcohol-intoxicated alcoho l users, the parathyroid glands do not respond normally to a hypocalce mic stimulus, and that depressed bone formation is uncoupled from acce lerated bone resorption.