Servicio de Medicina Interna, Hospital Universitario, Universidad de La Laguna, Ofra s/n, Tenerife, Canary Islands, Spain.
Alcohol Alcohol. 2011 Mar-Apr;46(2):148-55. doi: 10.1093/alcalc/agq098. Epub 2011 Jan 19.
Bone fractures are common in alcoholics.
To analyse which factors (ethanol consumption; liver function impairment; bone densitometry; hormone changes; nutritional status, and disrupted social links and altered eating habits) are related to bone fractures in 90 alcoholic men admitted to our hospitalization unit because of organic problems.
Bone homoeostasis-related hormones were measured in patients and age- and sex-matched controls. Whole-body densitometry was performed by a Hologic QDR-2000 (Waltham, MA, USA) densitometer, recording bone mineral density (BMD) and fat and lean mass; nutritional status and liver function were assessed. The presence of prevalent fractures was assessed by anamnesis and chest X-ray film.
Forty-nine patients presented at least one fracture. We failed to find differences between patients with and without fractures regarding BMD parameters. Differences regarding fat mass were absent, but lean mass was lower among patients with bone fracture. The presence of fracture was significantly associated with impaired subjective nutritional evaluation (χ² = 5.79, P = 0.016), lower vitamin D levels (Z = 2.98, P = 0.003) and irregular eating habits (χ² = 5.32, P = 0.02). Reduced lean mass and fat mass, and altered eating habits were more prevalent among patients with only rib fractures (n = 36) than in patients with multiple fractures and/or fractures affecting other bones (n = 13). These last were more closely related to decompensated liver disease. Serum vitamin D levels showed a significant relationship with handgrip strength (ρ = 0.26, P = 0.023) and lean mass at different parts of the body, but not with fat mass. By logistic regression analysis, only vitamin D and subjective nutritional evaluation were significantly, independently related with fractures.
Prevalent fractures are common among heavy alcoholics. Their presence is related more closely to nutritional status, lean mass and vitamin D levels than to BMD. Lean mass is more reduced, nutritional status is more impaired and there is a trend to more altered eating habits among patients with rib fractures, whereas multiple fractures depend more heavily on advanced liver disease.
骨折在酗酒者中很常见。
分析哪些因素（乙醇摄入；肝功能损害；骨密度测定；激素变化；营养状况以及社会关系破裂和饮食习惯改变）与 90 名因有机问题住院的酗酒男性患者的骨折有关。
测量患者和年龄及性别匹配的对照组中与骨稳态相关的激素。使用 Hologic QDR-2000（马萨诸塞州沃尔瑟姆）密度计进行全身骨密度测定，记录骨矿物质密度（BMD）以及脂肪和瘦体重；评估营养状况和肝功能。通过病史和胸部 X 光片评估是否存在常见骨折。
49 名患者至少有一处骨折。我们发现有骨折和无骨折的患者之间的 BMD 参数没有差异。脂肪量没有差异，但骨折患者的瘦体重较低。骨折的存在与主观营养评估受损（χ² = 5.79，P = 0.016），维生素 D 水平降低（Z = 2.98，P = 0.003）和不规则饮食习惯（χ² = 5.32，P = 0.02）显著相关。与多发性骨折和/或影响其他骨骼的骨折患者（n = 13）相比，仅肋骨骨折（n = 36）患者的瘦体重和脂肪量减少以及饮食习惯改变更为普遍。后者与肝功能失代偿更为密切相关。血清维生素 D 水平与握力（ρ=0.26，P=0.023）和身体不同部位的瘦体重呈显著正相关，但与脂肪量无关。通过逻辑回归分析，只有维生素 D 和主观营养评估与骨折有显著的独立关系。
酗酒者中常见骨折。它们的存在与营养状况，瘦体重和维生素 D 水平的关系比与 BMD 的关系更密切。与多发性骨折和/或影响其他骨骼的骨折患者相比，肋骨骨折患者的瘦体重降低更明显，营养状况更差，饮食习惯改变的趋势更大，而多发性骨折则更多地依赖于晚期肝病。
