Bone Disease in Chronic Alcoholism: The Value of Plasma Osteocalcin Measurement

Abstract

Osteoporosis is more common in chronic alcoholics than in age-matched controls. Possible aetiological factors are: malabsorption of calcium and vitamin D; liver disease and abnormal parathyroid function. The possibility that alcohol may directly affect osteoblastic function has, however, received little attention. We measured plasma osteocalcin, a protein synthesised specifically by osteoblasts, in chronic alcoholics. Our data show that these have low plasma osteocalcin but normal calcium, magnesium and parathormone, which suggest that alcohol may be directly toxic to osteoblasts.

Skeletal Response to Alcohol

“…The histological evidence for decreased bone formation is supported by consistent findings of reduced serum osteocalcin, a biochemical marker of bone formation (GonzalezCalvin et al, 1993;Labib et al, 1989;Laitinen et al, 1991aLaitinen et al, , 1992Laitinen et al, , 1994Nielsen et al, 1990;Rico et al, 1987). In contrast, the reported effects of alcohol abuse on histological and biochemical markers of bone resorption are contradictory, with evidence for no change as well as for decreased and increased bone resorption reported (Bikle et al, 1993(Bikle et al, , 1985Crilly et al, 1988;Diez et al, 1994;Laitinen et al, 1991aLaitinen et al, , 1994Lalor et al, 1986;Schnitzler and Solomon, 1984).…”

Effects of Perinatal Alcohol Exposure and Dietary Calcium Supplements on Skeletal and Dental Growth in Rats

“…14,28.30,31]. Chronic alcohol exposure was seen to result in decreased osteoblastic activity [30,31). prolonged mineralization rates and increased osteon resorption times [13.…”

“…30, 311. These findings suggest that chronic alcohol consumption may also be directly toxic to bone, having detrimental effects on bone forma tion with less pronounced suppressive effects on bone resorption [30,31 ]. It is also suggested that these effects may be reversible if the alcohol abuse is stopped before the bone disease becomes manifest [28].…”

Effects of Parathyroid Hormone on Bone Formation in a Rat Model for Chronic Alcohol Abuse

“…A LCOHOLICS OFTEN HAVE radiographic evidence of osteopenia, a greatly reduced bone mineral density, and reduced histologic and biochemical indices of bone formation (Bikle et al, 1985(Bikle et al, , 1993Crilly et al, 1988;Diez et al, 1994;Gonzalez-Calvin et al, 1993;Harding et al, 1988;Labib et al, 1989;Laitinen et al, 1992Laitinen et al, , 1993Lalor et al, 1986;Nielsen et al, 1990;Odvina et al, 1995;Pumarino et al, 1996;Schnitzler and Solomon, 1984;Spencer et al, 1986). There is also evidence that alcoholics are at a greater risk for receiving fractures than healthy individuals (Kanis et al, 1999;Kelepouris et al, 1995).…”