Alcohol dependence, smoking status, reproductive characteristics, and bone mineral density in premenopausal women
OBJECTIVE: The overall purpose of this study was to compare bone mineral density of the lumbar spine and femoral neck between premenopausal women who were alcohol dependent and those who were not, considering potential confounding effects of cigarette smoking and selective reproductive characteristics which may influence bone mineral density. DESIGN: Matched case-control. SETTING: Eastern Iowa community-based center for the treatment of chemical dependencies. POPULATION: Case subjects consisted of 25 Caucasian women, aged 20 to 40 years, who were recruited from women undergoing voluntary inpatient treatment for alcohol dependence. Control subjects were selected from women who participated in the 1992 follow-up of a population-based, longitudinal study of bone mineral density in premenopausal women. INTERVENTIONS: Bone mineral density of the femoral neck and lumbar spine were measured using a Lunar DPX-L dual energy x-ray absorptiometer (DEXA). Body composition was determined through height, weight, and densitometric measurement of total body fat. A structured interview was used to obtain information regarding characteristics potentially contributing to lower bone mineral density. Alcohol consumption was measured using the retrospective timeline method. Reproductive history was assessed through a series of questions. MAIN OUTCOME MEASURE(S): Bone mineral density was significantly lower in women who were alcohol dependent. Eighty-four percent of the alcohol-dependent women were smokers as compared to 44% of the controls. When controlling for smoking, there were no significant differences in femoral neck or lumbar spine bone mineral density between the two groups. Differences in several reproductive characteristics potentially associated with low bone mineral density were observed. RESULTS/CONCLUSIONS: The findings suggest that premenopausal women with histories of chronic alcohol misuse could enter menopause with substantially lower baseline bone mineral density than women without such histories. While the findings of this study are limited, they indicate that smoking could confound the true relationship between bone mineral density and alcohol dependence and should be included in all studies evaluating that relationship. Because the study was completed on a small nonrandom sample of women in treatment for alcohol dependence, it is not possible to generalize these findings to larger groups or to women who may be alcohol dependent but not in treatment. Although differences in bone mineral density between women who were alcohol dependent and others were demonstrated, future studies should be completed with enough resources and subjects to more adequately characterize the magnitude and nature of that association. [CINAHL abstract]
M. Kathleen Clark and M. R. Sowers. "Alcohol dependence, smoking status, reproductive characteristics, and bone mineral density in premenopausal women" Research in Nursing & Health 19.5 (1996): 399-408.
Available at: http://works.bepress.com/m_clark/1
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