[Phospho-calcium metabolism and bone histomorphometry in chronic alcoholism. Apropos of 25 cases]

Twenty five subjects, chronic alcoholics for more than five years, without any past history or clinical signs of portal hypertension or oedemato-ictero-ascitic decompensation, were examined by laboratory tests reflecting phosphoro-calcium metabolism and by transiliac bone biopsy with histomorphometric examination of nondecalcified bone. The subjects were fairly homogeneous in terms of liver function and liver disease, when present, was only minimal. The phosphoro-calcium parameters were generally normal, but hypomagnesaemia was observed. On the other hand, the histomorphometric study often revealed marked alterations: hyperosteoidosis: raised index of osteoid thickness (IOT) in 15 of the 25 cases, increase in the relative osteoid volume (ROV) in 12 cases and increase in the osteoid area (OA) in 8 cases. The bony trabecular volume (BTV) was only mildly reduced (13 out of 24) and there was increased resorption, reflected by an increase in the area of resorption (AR) seen in 15 cases, associated with a moderate increase in the area of periosteocytic lacunae (APOL). The essential changes consist of hyperosteoidosis with morphological osteomalacia in 60% of cases and reduction of the trabecular volume in 54%. Comparison of the different parameters reveals the following histomorphometric profile: BTV; AR; ROV; OA; IOT; APOL. Thus, histological bone changes occur in chronic alcholics before the appearance of signs of liver failure. These quantitatively minor changes are suggestive deficiency type bone.