Laitinen K, Kärkkäinen M, Lalla M, Lamberg-Allardt C, Tunninen R, Tähtelä R, Välimäki M
Third Department of Medicine, University of Helsinki, Finland.
Metabolism. 1993 Jul;42(7):875-81. doi: 10.1016/0026-0495(93)90063-t.
The effects of alcohol abuse on the bone of women have scarcely been investigated, although women are more prone than men to osteoporosis. We studied 19 noncirrhotic female alcoholics (aged 24 to 48 years) hospitalized for 2 weeks for withdrawal and three groups of control women (n = 182). Sixteen patients and all control subjects had regular menstrual cycles. Forearm bone mineral content (BMC) and axial bone mineral density (BMD) were measured by single-photon absorptiometry and dual-energy x-ray absorptiometry, respectively. Parameters of bone metabolism were analyzed at the beginning and end of the withdrawal period. BMC and BMD did not differ between patients and controls at any of the five measurement sites. On admission, bone formation of the alcoholics was depressed as reflected by osteocalcin levels (-48%, P < .01); it normalized during abstention (P < .01). Urinary hydroxyproline, a parameter of bone resorption, and serum intact parathyroid hormone were at the control level throughout the observation period. Serum ionized calcium level increased by 4% (P < .0001), and serum free fatty acid (FFA) levels decreased by 30% (P < .05) during withdrawal; there was an inverse correlation between changes in these two parameters (r = -.49, P < .05). On admission, serum concentrations of 25-hydroxyvitamin D3 [25-OH-D3] and 1,25-dihydroxyvitamin D3 [1,25-(OH)2-D3] were reduced by 46% (P < .001) and 16% (P = .16); these did not normalize during abstention. In conclusion, provided that liver cirrhosis and gonadal dysfunction are not contributing, even heavy drinking does not seem to decrease bone mass in young and middle-aged women.(ABSTRACT TRUNCATED AT 250 WORDS)
尽管女性比男性更容易患骨质疏松症,但酒精滥用对女性骨骼的影响却鲜有研究。我们研究了19名因戒酒住院两周的非肝硬化女性酗酒者(年龄在24至48岁之间)以及三组对照女性(n = 182)。16名患者和所有对照对象月经周期正常。分别采用单光子吸收法和双能X线吸收法测量前臂骨矿物质含量(BMC)和轴向骨矿物质密度(BMD)。在戒酒期开始和结束时分析骨代谢参数。在五个测量部位中的任何一个,患者和对照者的BMC和BMD均无差异。入院时,酗酒者的骨形成受到抑制,骨钙素水平反映了这一点(-48%,P <.01);在戒酒期间恢复正常(P <.01)。尿羟脯氨酸是骨吸收的一个参数,血清完整甲状旁腺激素在整个观察期内处于对照水平。戒酒期间血清离子钙水平升高了4%(P <.0001),血清游离脂肪酸(FFA)水平下降了30%(P <.05);这两个参数的变化呈负相关(r = -.49,P <.05)。入院时,血清25-羟基维生素D3 [25-OH-D3]和1,25-二羟基维生素D3 [1,25-(OH)2-D3]浓度分别降低了46%(P <.001)和16%(P =.16);在戒酒期间未恢复正常。总之,只要不存在肝硬化和性腺功能障碍,即使是大量饮酒似乎也不会降低年轻和中年女性的骨量。(摘要截选至250字)