Osteopenia in Alcoholics: Effect of Alcohol Abstinence
Osteopenia in Alcoholics: Effect of Alcohol Abstinence
复制标题
DOI：
10.1093/alcalc/agp038
复制
发表时间：
2009-09-01
影响因子：
2.8
通讯作者：
de los Angeles Gomez-Rodriguez, Maria
中科院分区：
文献类型：
--
作者：
Alvisa-Negrin, Julio;Gonzalez-Reimers, Emilio;de los Angeles Gomez-Rodriguez, Maria
目的：本研究的目的是评估酗酒者的骨矿物质密度（BMD）和含量（BMC）、骨钙素、血清端肽、甲状旁腺激素和维生素D，并确定戒酒6个月是否会导致这些参数的变化。方法：测定28例正常对照和77例酒精中毒患者血清骨钙素、胰岛素样生长因子1 （IGF-1）、末端肽（40例）和125例二羟基维生素D，其中48例在6个月后再次测定。在研究开始时和6个月后，所有患者都使用Hologic QDR-2000骨密度仪（Waltham， MA， USA）对骨密度进行了全身评估。结果：患者血清端肽水平（0.59 +/- 0.40 vs 0.19 +/- 0.10 nmol/100 ml, P < 0.001）、IGF-1水平（中位数= 49，四分位间距(IQR) = 31-121 ng/ml vs 135, IQR = 116-237 ng/ml, P < 0.001）、维生素D水平（26.5,IQR = 17.0-37.8 pg/ml vs 82.4, IQR = 60.9-107.4 pg/ml, P < 0.001）、骨钙素水平（2.1,IQR = 1.1-3.6 ng/ml vs 6.65, IQR = 4.9-8.8 ng/ml, P < 0.001）均高于对照组。患者还表现出较低的骨密度值、骨骼多个水平的Z-和t -评分以及总BMC减少。6个月后，继续饮酒的人骨量减少，而不饮酒的人骨量没有变化或增加，尤其是骨盆、右臂、总骨密度和BMC的差异明显。与此同时，不喝酒的人骨钙素显著增加（而继续喝酒的人则有所减少）。两组血清端肽均升高。结论：酒精摄入导致骨质减少和血清骨钙素下降，戒酒后情况有所改善，而继续饮酒者两项指标均恶化。
Aims: The aims of this study were to assess bone mineral density (BMD) and content (BMC), osteocalcin, serum telopeptide, PTH and vitamin D in alcoholics, and to determine if a 6-month period of abstinence leads to changes in these parameters. Methods: Serum osteocalcin, insulin-like growth factor 1 (IGF-1), telopeptide (40 patients) and 1,25 dihydroxyvitamin D, were measured in 28 controls and 77 alcoholic patients, 48 of whom were evaluated again 6 months later. All patients underwent whole-body assessment of BMD by a Hologic QDR-2000 (Waltham, MA, USA) bone densitometer, at the beginning of the study and 6 months later. Results: Patients showed higher serum telopeptide levels (0.59 +/- 0.40 versus 0.19 +/- 0.10 nmol/100 ml, P < 0.001), lower IGF-1 [median = 49, interquartile range (IQR) = 31-121 ng/ml versus 135, IQR = 116-237 ng/ml, P < 0.001], vitamin D [26.5, IQR = 17.0-37.8 pg/ml versus 82.4 (IQR = 60.9-107.4 pg/ml, P < 0.001] and osteocalcin (2.1, IQR = 1.1-3.6 ng/ml versus 6.65, IQR = 4.9-8.8 ng/ml, P < 0.001) than those in controls. Patients also showed lower BMD values, Z- and T-scores at many levels of the skeleton and reduced total BMC. After 6 months, those who continued drinking showed a loss of bone mass, whereas those who abstained showed either no change or increase, differences being especially marked at pelvis, right arm and total BMD and BMC. Simultaneously, abstainers showed a significant increase in osteocalcin (versus a decrease among those who continued drinking). Serum telopeptide increased in both groups. Conclusion: Ethanol consumption leads to osteopenia, and decreased serum osteocalcin, which improve with abstinence, whereas those who continue drinking show a worsening of both parameters.