[Assessment of bone status in intermittent and continuous alcoholics, without evidence of liver damage]

The effect of chronic alcoholism on bone mass and density has been a subject of considerable controversy. The goal of the present study was to evaluate bone mineral content and density in 2 groups of alcoholic men without evidence of liver damage and determine if the modality of alcohol consumption could cause an alcohol-mediated bone loss. We studied 70 alcoholic non cirrhotic men divided into intermittent (n = 38) and continuous (n = 32) drinkers. They were compared to 109 normal men. Dual photon densitometry technique using a Gd 153 source was utilized and bone mineral density (BMD) of lumbar spine, femoral neck, Ward's triangle, trochanter, total body bone density (TBBD) and mineral (TBBM) were measured. Hematologic, serum and urinary tests of mineral metabolism were also carried out. No significant differences were found in lumbar spine BMD between normals and alcoholics regardless of the type of alcohol consumption and duration of alcoholism. In the femoral neck a significant decrease in BMD was found in alcoholics when plotted as regression curves (r = 25; p = 0.02). In this site duration of alcoholism was significantly correlated to decreased BMD in the total group of alcoholics (r = 0.27; p = 0.02) and also in the continuous drinker group (r = 0.39; p = 0.02) but not in the intermittent drinker group. At the whole body level, BMD did not significantly differ between alcoholics and normals (p = 0.08) except in continuous (r = 0.40; p = 0.02) when considered duration of alcohol abuse. Total bone mineral was significantly lower in alcoholics (p < 0.001) and the subgroups compared to normals, and correlated with duration of alcohol abuse (p = 0.01). Chemical values revealed normal calcium, phosphorus, alkaline phosphatases, PTH and Ca/Cr concentration. Only serum magnesium was found diminished in 16.6% of studied subjects. We conclude, that pure alcoholism may affect femoral neck density and total body mineral content, being proportional to the duration of alcohol abuse. Spine density appears unaffected. The type of alcoholic abuse was less important than its duration to cause bone mass abnormalities.