[Alcoholic osteopathy]

Alcohol intake is one of the multiple risk factors for developing osteoporosis. Alcohol has direct toxic effects on osteoblasts which determines lower osteocalcin levels at an early stage, and histomorphometric changes later on. Some authors found not only diminished bone formation in alcoholics, but also increased bone resorption. The effect of alcoholism on calciotropic hormones includes fall of PTH serum levels after an acute or moderate alcohol intake, causing transient hypoparathyroidism. In chronic alcoholism, serum levels of vitamin D and its metabolites are decreased independently of any liver disease, probably related to alcohol influence on enzymatic systems. The mineral homeostasis of alcoholics is affected: hypocalcemia is found in acute intoxication, with hypo or hypermagnesemia. In chronic alcoholism the serum calcium values tend to be normal. Alcohol intake causes multiple endocrine changes that lead to hypogonadism in both sexes. The stimulation of hypothalamus-hypophyseal-adrenal axis contributes to the alcoholic bone disease, because of the adverse effects of corticoids on bone. Caloric and protein malnutrition, in addition to a dissipated life style are additional risk factors for the development of osteoporosis.