Alcohol: A Simple Nutrient with Complex Actions on Bone in the Adult Skeleton.
Alcohol: A Simple Nutrient with Complex Actions on Bone in the Adult Skeleton.
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DOI：
10.1111/acer.13000
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发表时间：
2016-04
期刊：
影响因子：
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通讯作者：
Iwaniec UT
中科院分区：
文献类型：
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作者：
Gaddini GW;Turner RT;Grant KA;Iwaniec UT
酒精是饮食中重要的非必需成分，但饮酒对骨骼健康的整体影响，特别是在适度水平上，还没有得到很好的理解。骨骼健康很重要，因为骨折大大降低了生活质量，是老年人发病率和死亡率的主要原因。经常饮酒是骨骼成熟后最常见的，强调了解成年人饮酒对骨骼的影响的重要性。本文综述了酒精对成人骨骼的复杂影响。强调了自2000年以来发表的评估酒精对成年人骨骼影响的研究以及成熟的动物模型。据报道，轻度至中度饮酒通常是有益的，导致骨矿物质密度（BMD）较高，并减少与年龄相关的骨质流失，而重度饮酒通常与BMD降低，骨质受损和骨折风险增加有关。骨重建是维持成人健康骨骼的主要机制，骨重建功能障碍可导致骨丢失和/或骨质量降低。轻度至中度酒精可能通过减缓骨重建的速度对老年人产生有益的影响，但轻度至中度酒精对年轻人骨重建的影响不太确定。酒精对重度饮酒者骨重塑的具体影响甚至更不确定，因为这些影响往往被不健康的生活方式选择，酒精相关疾病和改变的内分泌信号所掩盖。虽然在了解酒精对骨骼的复杂作用方面取得了进展，但仍有许多问题有待确定。有限的证据表明，年龄，骨骼部位评估，持续时间和饮酒模式的重要变量。很少有研究系统地评估这些因素的影响已经进行，应优先为未来的研究。此外，在骨成熟动物中进行的研究有可能揭示酒精和相关共病因素对骨重建的确切作用的机理。
Alcohol is an important nonessential component of diet, but the overall impact of drinking on bone health, especially at moderate levels, is not well understood. Bone health is important because fractures greatly reduce quality of life and are a major cause of morbidity and mortality in the elderly. Regular alcohol consumption is most common following skeletal maturity, emphasizing the importance of understanding the skeletal consequences of drinking in adults. This review focuses on describing the complex effects of alcohol on the adult skeleton. Studies assessing the effects of alcohol on bone in adult humans as well as skeletally-mature animal models published since the year 2000 are emphasized. Light to moderate alcohol consumption is generally reported to be beneficial, resulting in higher bone mineral density (BMD) and reduced age-related bone loss, whereas heavy alcohol consumption is generally associated with decreased BMD, impaired bone quality and increased fracture risk. Bone remodeling is the principle mechanism for maintaining a healthy skeleton in adults and dysfunction in bone remodeling can lead to bone loss and/or decreased bone quality. Light to moderate alcohol may exert beneficial effects in older individuals by slowing the rate of bone remodeling but the impact of light to moderate alcohol on bone remodeling in younger individuals is less certain. The specific effects of alcohol on bone remodeling in heavy drinkers is even less certain because the effects are often obscured by unhealthy lifestyle choices, alcohol-associated disease, and altered endocrine signaling. Although there have been advances in understanding the complex actions of alcohol on bone, much remains to be determined. Limited evidence implicates age, skeletal site evaluated, duration and pattern of drinking as important variables. Few studies systematically evaluating the impact of these factors have been conducted and should be made a priority for future research. In addition, studies performed in skeletally mature animals have potential to reveal mechanistic insights into the precise actions of alcohol and associated co-morbidity factors on bone remodeling.