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Alcohol intake as a risk factor for fracture
John A Kanis1, Helena Johansson, Olof Johnell
1WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK. w.j.pontefract@shef.ac.uk
Summary
Moderate alcohol consumption increases fracture risk. Daily intake exceeding two units elevates the risk of any fracture, osteoporotic fracture, and hip fracture, independent of bone mineral density.
Area of Science:
- Gerontology and Bone Health
- Epidemiology of Osteoporosis
- Alcohol Consumption and Health Outcomes
Background:
- High alcohol intake is detrimental to skeletal health.
- The impact of moderate alcohol consumption on fracture risk remains unclear.
- Understanding alcohol's effect on bone health is crucial for public health strategies.
Purpose of the Study:
- To quantify the international risk of alcohol consumption on fracture incidence.
- To investigate the relationship between alcohol intake, age, sex, and bone mineral density (BMD).
- To identify a potential threshold for alcohol intake associated with increased fracture risk.
Main Methods:
- Analysis of 5,939 men and 11,032 women from three prospective cohorts (CaMos, DOES, Rotterdam Study).
- Follow-up for 75,433 person-years, examining risk of any fracture, osteoporotic fracture, and hip fracture.
- Poisson regression models used, with results merged using weighted beta-coefficients; age and BMD as covariates.
Main Results:
- Alcohol intake showed a nonlinear association with increased osteoporotic and hip fracture risk.
- No significant risk increase observed for daily intakes of two units or less.
- Above two units daily, increased risk for any fracture (RR=1.23), osteoporotic fracture (RR=1.38), and hip fracture (RR=1.68) was noted.
Conclusions:
- Alcohol consumption poses a significant fracture risk, independent of bone mineral density.
- A daily intake threshold of two units appears to differentiate risk levels.
- Findings support the inclusion of alcohol intake in fracture risk assessment strategies.