Feskanich D, Korrick S A, Greenspan S L, Rosen H N, Colditz G A
Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
J Womens Health. 1999 Jan-Feb;8(1):65-73. doi: 10.1089/jwh.1999.8.65.
Chronic alcohol abuse is associated with low bone density and high risk of fracture. However, moderate alcohol consumption may help to maintain bone density in postmenopausal women by increasing endogenous estrogens or by promoting secretion of calcitonin. We conducted a prospective study among a sample of 188 white postmenopausal women (ages 50-74) from the Nurses' Health Study who participated in a health examination between 1993 and 1995 that included bone density assessments of the lumbar spine and proximal femur. Long-term alcohol intake was calculated as the average of the 1980 and 1990 measures from a food frequency questionnaire. Women who consumed 75 g or more of alcohol per week had significantly higher bone densities at the lumbar spine compared with non-drinking women (0.951 vs. 0.849 g/cm2, p = 0.002) after adjusting for age, body mass index (kg/m2), age at menopause, use of postmenopausal estrogens, and smoking status. Further adjustment for physical activity and daily intakes of calcium, vitamin D, protein, and caffeine did not alter the results. We also observed a linear increase in spinal bone density over increasing categories of alcohol intake (p = 0.002), suggesting that alcohol intakes of less than 75 g/week may also be of benefit. This positive association was observed among both current users and never users of postmenopausal estrogens. In contrast to the lumbar spine, femoral bone density was not higher among drinkers compared with nondrinkers, although density did increase among drinkers with increasing level of alcohol consumption. Further research is needed to determine whether moderate alcohol consumption can help to protect against spinal fractures in postmenopausal women. This finding must also be evaluated within a larger scope of the risks and benefits of alcohol on heart disease, breast cancer, and hip fractures.
长期酗酒与骨密度降低及骨折风险增加有关。然而，适度饮酒可能有助于绝经后女性维持骨密度，其机制可能是通过增加内源性雌激素或促进降钙素的分泌。我们对护士健康研究中的188名白人绝经后女性（年龄50 - 74岁）进行了一项前瞻性研究，这些女性在1993年至1995年期间参加了健康检查，检查项目包括腰椎和股骨近端的骨密度评估。长期酒精摄入量通过食物频率问卷中1980年和1990年测量值的平均值来计算。在调整了年龄、体重指数（kg/m²）、绝经年龄、绝经后雌激素使用情况和吸烟状况后，每周饮酒75克或更多的女性与不饮酒女性相比，腰椎骨密度显著更高（分别为0.951 vs. 0.849 g/cm²，p = 0.002）。进一步调整身体活动以及钙、维生素D、蛋白质和咖啡因的每日摄入量后，结果未改变。我们还观察到随着酒精摄入量增加，脊柱骨密度呈线性增加（p = 0.002），这表明每周饮酒量少于75克可能也有益处。在目前使用和从未使用绝经后雌激素的女性中均观察到这种正相关关系。与腰椎不同，饮酒者的股骨骨密度与不饮酒者相比并不更高，尽管饮酒者的骨密度确实随着酒精摄入量的增加而增加。需要进一步研究以确定适度饮酒是否有助于预防绝经后女性的脊柱骨折。这一发现还必须在酒精对心脏病、乳腺癌和髋部骨折的风险与益处这一更大范围内进行评估。
