Markers of bone resorption and formation during abstinence in male alcoholic patients

Alcohol Clin Exp Res. 2012 Dec;36(12):2059-64. doi: 10.1111/j.1530-0277.2012.01834.x. Epub 2012 Sep 14.


Background: Reduced bone mineral density (BMD) is commonly found in alcohol-dependent patients. Many risk factors have been reported, yet the course of markers of bone formation and resorption in abstinent alcoholic patients have not received much attention.

Methods: In a prospective longitudinal study, we investigated BMD in male abstinent inpatients of an alcohol rehabilitation clinic aged 21 to 50 years at baseline and after 8 weeks of treatment. At baseline and at week 8, all patients had blood drawn for the analysis of liver function tests, calcium, phosphate, parathormone, 25-hydroxyvitamin D, osteocalcin (OC), serum crosslaps, sex hormones, and prolactin. BMD was determined by dual X-ray absorptiometry in the lumbar spine and the proximal right femur. We also determined the amount of physical activity prior to inpatient treatment by using the International Physical Activity Questionnaire (IPAQ).

Results: Low BMD was found in 15.1% of the patients for the lumbar spine, in 5.7% for the femoral neck, and in 1.9% for the total hip. BMD differed significantly from normal values, in the lumbar spine and in the femoral neck. At baseline, crosslaps were elevated in 34% of the patients, while OC levels were lowered in 17%. Over the course of the 8 weeks, we found a significant increase in OC plasma levels, indicating a higher rate of bone formation during continuous abstinence. There were also positive correlations between IPAQ scores and BMD as reflected by Z-scores in all regions, pointing to a protective effect of physical activity.

Conclusions: In summary, this report confirms earlier cross-sectional studies of lowered BMD in alcoholic noncirrhotic men. We could also demonstrate that the initial imbalance between bone formation and resorption seems to adjust toward a balance between the two during abstinence.

MeSH terms

  • Absorptiometry, Photon
  • Adult
  • Alcoholism / blood
  • Alcoholism / complications*
  • Biomarkers / blood
  • Bone Density / drug effects
  • Bone Resorption / blood
  • Bone Resorption / chemically induced*
  • Calcium / blood
  • Collagen / blood
  • Gonadal Steroid Hormones / blood
  • Humans
  • Liver Function Tests
  • Male
  • Middle Aged
  • Osteocalcin / blood
  • Osteogenesis / drug effects*
  • Parathyroid Hormone / blood
  • Peptide Fragments / blood
  • Phosphates / blood
  • Prolactin / blood
  • Prospective Studies
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Young Adult


  • Biomarkers
  • Gonadal Steroid Hormones
  • Parathyroid Hormone
  • Peptide Fragments
  • Phosphates
  • glutamyl-lysyl-alanyl-histidyl-aspartyl-glycyl-glycyl-arginine
  • Osteocalcin
  • Vitamin D
  • Prolactin
  • Collagen
  • 25-hydroxyvitamin D
  • Calcium