Alcohol intake as a risk factor for fracture.
Journal article, 2005
High intakes of alcohol have adverse effects on skeletal health, but evidence for the effects of moderate consumption are less secure. The aim of this study was to quantify this risk on an international basis and explore the relationship of this risk with age, sex, and bone mineral density (BMD). We studied 5,939 men and 11,032 women from three prospectively studied cohorts comprising CaMos, DOES, and the Rotterdam Study. Cohorts were followed for a total of 75,433 person-years. The effect of reported alcohol intake on the risk of any fracture, any osteoporotic fracture, and hip fracture alone was examined using a Poisson model for each sex from each cohort. Covariates examined included age and BMD. The results of the different studies were merged using weighted beta-coefficients. Alcohol intake was associated with a significant increase in osteoporotic and hip fracture risk, but the effect was nonlinear. No significant increase in risk was observed at intakes of 2 units or less daily. Above this threshold, alcohol intake was associated with an increased risk of any fracture (risk ratio [RR] = 1.23; 95% CI, 1.06-1.43), any osteoporotic fracture (RR = 1.38; 95% CI, 1.16-1.65), or hip fracture (RR = 1.68; 95% CI, 1.19-2.36). There was no significant interaction with age, BMD, or time since baseline assessment. Risk ratios were moderately but not significantly higher in men than in women, and there was no evidence for a different threshold for effect by gender. We conclude that reported intake of alcohol confers a risk of some importance beyond that explained by BMD. The validation of this risk factor on an international basis permits its use in case-finding strategies.
Bone Density
Middle Aged
physiopathology
physiopathology
Female
etiology
Risk Assessment
etiology
Bone
Prospective Studies
Fractures
Risk Factors
adverse effects
Hip Fractures
physiopathology
Male
Follow-Up Studies
Alcohol Drinking
Osteoporosis
Age Factors
Humans
Adult
etiology
Sex Factors
Author
John A Kanis
Helena Johansson
University of Gothenburg
Olof Johnell
Anders Odén
Chalmers, Mathematical Sciences, Mathematical Statistics
University of Gothenburg
Chris De Laet
John A Eisman
Huibert Pols
Alan Tenenhouse
Osteoporosis International
0937-941X (ISSN) 1433-2965 (eISSN)
Vol. 16 7 737-42Subject Categories
Endocrinology and Diabetes
Physiology
DOI
10.1007/s00198-004-1734-y
PubMed
15455194