Abstract
To assess whether vertebral fractures are associated with osteopenia in chronic alcoholic patients, a transversal study was carried out in 76 chronic alcoholic males and 62 age-matched healthy males. Lumbar bone mineral density (BMD) by dual photon absorptiometry and spinal chest X-ray films were done in all patients. Twenty-seven patients (36%) had vertebral fractures, but only 5 of them had a BMD below the fracture threshold. Twenty-two patients (29%) had osteoporosis by densitometric criteria. There were no significant differences in lumbar BMD between alcoholic patients with and without vertebral fractures (1.11±0.2 versus 1.13±0.2, P=ns). Previous trauma was recorded in 24 of the 27 patients with vertebral fractures and in 28 of the 49 patients without vertebral fractures (P<0.001). Moreover, patients with vertebral fractures had more peripheral fractures than patients without vertebral fractures (81% versus 49%, P=0.01). Only one patient was aware of a previous episode of traumatic vertebral fracture. In conclusion, chronic alcoholics frequently have traumas and vertebral fractures, the latter despite having a lumbar BMD above the fracture threshold, suggesting a frequent but unrecognized association between both processes. These results suggest that both spine films and BMD measurements should be obtained for diagnosis of osteoporosis in alcoholic patients.
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References
Lucas EG (1987) Alcohol in industry. BMJ 294:460–461
Kristensson H, Lunden A, Nilsson BE (1980) Fracture incidence and diagnostic Roentgen in alcoholics. Acta Orthop Scand 51:205–207
Rico H (1990) Alcohol and bone disease. Alcohol Alcohol 25: 345–352
Laitinen K, Valimaki M (1991) Alcohol and bone. Calcif Tissue Int (suppl) 49:70–73
Grisso JA, Chiu GY, Maislin G, Steinmann WC, Portale J (1991) Risk factors for hip fractures in men: a preliminary study. J Bone Miner Res 6:865–868
Nilsson BE (1970) Conditions contributing to fracture of the femoral neck. Acta Chir Scand 136:383–384
Felson DT, Kiel DP, Anderson JJ, Kannel WB (1988) Alcohol consumption and hip fractures: the Framingham study. Am J Epidemiol 128:1102–1110
Lindsell DR, Wilson AG, Maxwell JD (1982) Fractures on the chest radiograph in detection of alcoholic liver disease. BMJ 285:597–599
Israel Y, Orrego H, Holt S, Macdonald DW, Meema HE (1980) Identification of alcohol abuse: thoracic fractures on routine X-rays as indicators of alcoholism. Alcohol Clin Exp Res 4:420–422
Seeman E, Melton LJ III, O'Fallon WM, Riggs BL (1983) Risk factors for spinal osteoporosis in men. Am J Med 75:977–983
Peris P, Parés A, Guañabens N, Pons F, Martinez de Osaba M, Caballería J, Rodés J, Muñoz-Gomez J (1992) Reduced spinal and femoral bone mass and deranged bone mineral metabolism in chronic alcoholics. Alcohol Alcohol 27:619–625
Diamond T, Stiel D, Lunzer M, Wilkinson M, Posen S (1989) Ethanol reduces bone formation and may cause osteoporosis. Am J Med 86:282–288
Crilly RG, Anderson C, Hogan D, Delaquerriére-Richardson L (1988) Bone histomorphometry, bone mass, and related parameters in alcoholic males. Calcif Tissue Int 43:269–276
Cooper C, Atkinson EJ, O'Fallon M, Melton LJ III (1992) Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985–1989. J Bone Miner Res 7:221–227
Caballería L, Montull S, Parés A, Deulofeu R, Caballería, Rodés J (1988) Utilidad de los marcadores biológicos para la detección del alcoholismo y para el diagnóstico de la enfermedad alcohólica. Med Clin (Barc) 91:244–248
Luengo M, Picado C, Del Rio L, Guañabens N, Montserrat JM, Setoain J (1990) Treatment of steroid-induced osteopenia with calcitonin in corticosteroid-dependent asthma. Am Rev Respir Dis 142:104–107
Nordin BEC (1987) The definition and diagnosis of osteoporosis. Calcif Tissue Int 40:57–58
Luengo M, Picado C, Del Rio L, Guañabens N, Montserrat JM, Setoain J (1991) Vertebral fractures in steroid-dependent asthma and involutional osteoporosis: a comparative study. Thorax 46:803–806
Tilyard MW, Spears GFS, Com B, Thomson J, Dovey S (1992) Treatment of postmenopausal osteoporosis with calcitriol or calcium. N Engl J Med 326:357–362
Ross PD, Wasnich RD, Heilbrun LK, Vogel JM (1987) Definition of a spine fracture threshold based upon prospective fracture risk. Bone 8:271–278
Mann T, Oviatt SK, Wilson D, Nelson D, Orwoll ES (1992) Vertebral deformity in men. J Bone Miner Res 7:1259–1265
Johnson RD, Davidson S, Saunders JB, Williams R (1984) Fractures on chest radiographs as indicators of alcoholism in patients with liver disease. BMJ 288:365–366
Keso L, Kivisaari A, Salaspuro M (1988) Fractures on chest radiographs in detection of alcoholism. Alcohol Alcohol 23:53–56
Redmond AD (1982) Chest radiography as a marker of alcoholism. BMJ 285:810
Tuberculosis and the alcoholic (1987). Lancet 2:460–461
Bikle DD, Stesin A, Halloran B, Steinbach L, Recker R (1993) Alcohol-induced bone disease: relationship to age and parathyroid hormone levels. Alcohol Clin Exp Res 17:690–695
Gratacós J, Collado A, Peris P, Pons X, Cañete J, Brancós MA, Muñoz-Gomez J (1992) Osteoporosis en la espondilitis anquilosante. Rev Esp Reumatol 19:215–216
De Marchi S, Basile A, Grimaldi F, Macor C, Vitale G, Cecchin E (1984) Fractures and hypercalciuria: two markers of severe dependence in alcoholics. BMJ 288:1457–1458
Crilly RG, Delaquerriére-Richardson L (1990) Current bone mass and body weight changes in alcoholic males. Calcif Tissue Int 46:169–172
Lalor BC, France MW, Powell D, Adams PH, Counihan TB (1986) Bone metabolism and chronic alcohol abuse. Q J Med 229:497–511
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Peris, P., Guañabens, N., Parés, A. et al. Vertebral fractures and osteopenia in chronic alcoholic patients. Calcif Tissue Int 57, 111–114 (1995). https://doi.org/10.1007/BF00298430
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DOI: https://doi.org/10.1007/BF00298430