Barbour, J.; Kelly, C.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA102
Academic Journal
Background: Men with alcohol dependence and related liver dysfunction have multiple risk factors for metabolic bone disease. In a case controlled study we studied the prevalence of osteoporosis and we identified surrogate markers of Iow bone mass and risk factors for osteoporosis in these patients. Method: We prospectively assessed 20 consecutive male inpatients with alcohol dependence syndrome who drank in excess of 40 units per week. They all had clinical evidence of cirrhosis (ascites) or deranged liver function tests (LFTs) for greater than 6 months. Patients with additional causes for liver disease or previous bone densitometry were excluded. Body mass index (BMI), alcohol consumption, bilirubin, ALT, prothrombin, albumin, platelets, MCV, Childs-Pugh grading, and free testosterone index were measured in all patients. 20 aged matched individuals from the clinical and portering staff of the hospital (who drank less than 28 units of alcohol per week) served as case controls. Peripheral bone mineral density (BMD) was measured in the non-dominant wrist of all subjects. Results: 9 patients (45%) had T scores of 2.5 S.D. or more below normal (osteoporosis) and the aged matched controls were similarly reduced in only 1 (5%). The mean absolute BMD for the patients was 0.497 g/cm², which was significantly lower than case controls at 0.579 g/cm² (p = 0.016). BMD correlated closely with BMI (r = 0.68; p < 0.001) in the alcoholics, but not with consumption or duration of alcohol, or any of the clinical or chemical markers of severity of liver disease. Free testosterone index was reduced in 11 patients (55%) but this failed to correlate with BMD. Conclusion: As in other studies we have found a high incidence of Iow bone mass and frank osteoporosis in alcoholics with related liver dysfunction. BMI, however, was the only factor that correlated with BMD and is therefore potentially a good surrogate marker for osteoporosis in this patient group and may be the...


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