[Alcohol-induced osteopenia]

There is clear evidence of a propensity to fractures and the development of osteomalacia, osteoporosis, and mixed forms in chronic alcoholics. Osteomalacia is associated with impaired vitamin D status, probably due to enzyme induction in liver and kidney and development of a secondary intestinal hyperparathyroidism. The development of osteoporosis is multifactorial, but seems to arise mainly through reduction in bone formation and reduced dietary protein and calcium intake. Low testosterone levels may also contribute to osteoporosis.