Callaci John J, Juknelis Dainius, Patwardhan Avinash, Sartori Mark, Frost Nathan, Wezeman Frederick H
Department of Orthopaedic Surgery and Rehabilitation, Loyola University Stritch School of Medicine, Maywood, Illinois, USA.
Alcohol Clin Exp Res. 2004 Jan;28(1):182-91. doi: 10.1097/01.ALC.0000108661.41560.BF.
Chronic alcohol consumption reduces bone mass and strength, increasing fracture risk for alcohol abusers. Mechanisms underlying this vulnerability involve modulation of bone remodeling. Direct effects of alcohol on bone formation have been documented; those on bone resorption are less well studied. Skeletal effects of exposure to high blood alcohol concentrations (BAC's) attained during binge drinking have not been studied. We examined the effects of repeated binge-like alcohol treatment on bone resorption, bone mineral density and vertebral compressive strength in adult male rats treated with the aminobisphosphonate, risedronate.
A binge alcohol exposure model was developed using intraperitoneal (IP) injection to administer a 20% (vol/vol) alcohol/saline solution (3 g/kg, 1X/day) on four consecutive days for 1, 2 or 3 weeks in 400 g rats, with and without weekly risedronate treatment (0.5 mg/kg, 1X/week). Total serum deoxypyridinoline (Dpd) a crosslink of bone type collagen released during resorption was measured by ELISA. Bone mineral density (BMD) was measured using peripheral quantitative computed tomography (pQCT). Vertebral compressive strength was determined using an Instron materials testing machine. Trabecular integrity was analyzed by computer-aided trabecular analysis system (TAS).
Peak BAC's averaged 308.5 +/- 12 mg/dL; average BAC was 258.6 +/- 28.7 mg/dL at time of euthanasia. No significant effects of treatment were observed after 1 or 2 weeks of binge alcohol exposure. At 3 weeks of alcohol treatment serum Dpd was significantly increased (205%, p < 0.05) over controls. Bone mineral density (BMD) in cancellous bone of distal femur and lumbar spine were significantly decreased (34% and 21% respectively, p < 0.01) after 3 weeks of binge treatment. Vertebral (L4) compressive strength (maximum load sustained before failure) also decreased (27%, p < 0.05) after 3 binge alcohol cycles. Risedronate maintained the Dpd level (p < 0.01), BMD (p < 0.001) and vertebral structural biomechanical properties (p < 0.01) of binge-treated rats at control levels (E vs ER). Indices of trabecular architectural integrity [Trabecular bone volume/tissue volume (BV/TV), bone area (BAR) and trabecular separation (Tb.Sp)] analyzed at week 3 showed (BV/TV) and (BAR) were significantly reduced in alcohol-binged rats (p < 0.01), while (Tb.Sp) was significantly increased (p < 0.01). Risedronate also maintained the trabecular architectural indices of binge-treated rats at control levels (E versus ER, p < 0.01).
In adult male rats, BAC's reflective of those attained during alcoholic binge drinking may affect the skeleton in part by stimulating bone resorption, an effect mitigated by risedronate.
长期饮酒会降低骨量和骨强度,增加酗酒者的骨折风险。这种易感性的潜在机制涉及骨重塑的调节。酒精对骨形成的直接影响已有文献记载;而对骨吸收的影响则研究较少。暴饮期间达到的高血液酒精浓度(BAC)对骨骼的影响尚未得到研究。我们研究了反复进行类似暴饮的酒精处理对用氨基双膦酸盐利塞膦酸盐治疗的成年雄性大鼠的骨吸收、骨矿物质密度和椎体抗压强度的影响。
建立了一个暴饮酒精暴露模型,通过腹腔内(IP)注射,在400克大鼠中连续4天每天给予20%(体积/体积)酒精/盐水溶液(3克/千克),持续1、2或3周,同时有或没有每周一次的利塞膦酸盐治疗(0.5毫克/千克,每周一次)。通过ELISA测量血清中骨型胶原在吸收过程中释放的交联物总脱氧吡啶啉(Dpd)。使用外周定量计算机断层扫描(pQCT)测量骨矿物质密度(BMD)。使用Instron材料试验机测定椎体抗压强度。通过计算机辅助小梁分析系统(TAS)分析小梁完整性。
BAC峰值平均为308.5±12毫克/分升;安乐死时平均BAC为258.6±28.7毫克/分升。在暴饮酒精暴露1或2周后未观察到治疗的显著效果。在酒精治疗3周时,血清Dpd比对照组显著增加(205%,p<0.05)。暴饮治疗3周后,股骨远端和腰椎的松质骨骨矿物质密度(BMD)显著降低(分别为34%和21%,p<0.01)。在3个暴饮酒精周期后,椎体(L4)抗压强度(失效前承受的最大载荷)也降低了(27%,p<0.05)。利塞膦酸盐将暴饮治疗大鼠的Dpd水平(p<0.01)、BMD(p<0.001)和椎体结构生物力学特性(p<0.01)维持在对照水平(E组与ER组)。在第3周分析的小梁结构完整性指标[小梁骨体积/组织体积(BV/TV)、骨面积(BAR)和小梁间距(Tb.Sp)]显示,暴饮酒精的大鼠中(BV/TV)和(BAR)显著降低(p<0.01),而(Tb.Sp)显著增加(p<0.01)。利塞膦酸盐也将暴饮治疗大鼠的小梁结构指标维持在对照水平(E组与ER组,p<0.01)。
在成年雄性大鼠中,反映酒精暴饮期间达到的BAC水平可能部分通过刺激骨吸收影响骨骼,而利塞膦酸盐可减轻这种影响。