Risk Factors for Fracture in Alcohol-dependent, Pre-menopausal Females

Abstract

Aims: Alcoholism is known to be associated with increased risk of fracture. This study aimed to study bone turnover following alcohol detoxification and to investigate lifestyle factors for low bone density that might coexist with alcohol dependency, which might be amenable to modification. Method: Pre-menopausal female participants were recruited from an alcohol-use dependency unit to a cross-sectional study. A lifestyle questionnaire, including alcohol history, smoking, physical activity, dietary calcium intake, falls, and fracture history was completed. Quantitative heel ultrasonography was performed and broadband ultrasound attenuation (BUA), speed of sound (SOS), t score, and z score were recorded. Blood was taken for bone-turnover markers at baseline and day 5 following admission for alcohol withdrawal.Results: The mean age (SD) of alcohol dependent participants was 41.6 (8.3) years, with participants reporting high levels of current cigarette smoking, physical inactivity, and falls. BUA, SOS, t scores, and z scores were lower than the age-matched reference range in alcohol-dependent participants. Levels of type 1 procollagen (P1NP) increased significantly after five days (p < .001). Conclusions: Alcohol-dependent, pre-menopausal individuals have multiple risk factors for fracture, beyond alcohol excess. These should be addressed and targeted as modification may reduce fracture risk, especially given the apparent recovery of bone turnover on the withdrawal of alcohol.