Alcohol consumption, bone density, and hip fracture among older adults: The cardiovascular health study

Department of Public Health, Cornell University, Итак, New York, United States
Osteoporosis International (Impact Factor: 4.17). 06/2007; 18(5):593-602. DOI: 10.1007/s00198-006-0287-7
Source: PubMed


Previous studies have found inconsistent relationships of alcohol consumption with risk of hip fracture, and the importance of bone mineral density and risk of falls in mediating such a relationship has not been determined.
As part of the Cardiovascular Health Study, a population-based cohort study of adults aged 65 years and older from four U.S. communities, 5,865 participants reported their use of beer, wine, and liquor yearly. We identified cases of hip fracture unrelated to malignancy or motor vehicle accidents using hospitalization discharge diagnoses. A subgroup of 1,567 participants in two communities underwent dual-energy x-ray absorptiometry scans to assess bone mineral density.
A total of 412 cases of hip fracture occurred during an average of 12 years of follow-up. There was a significant U-shaped relationship between alcohol intake and risk of hip fracture (p quadratic 0.02). Compared with long-term abstainers, the adjusted hazard ratios for hip fracture were 0.78 (95% confidence interval [CI], 0.61-1.00) among consumers of up to 14 drinks per week and 1.18 (95% CI, 0.77-1.81) among consumers of 14 or more drinks per week. Alcohol intake was associated with bone mineral density of the total hip and femoral neck in a stepwise manner, with approximately 5% (95% CI, 1%-9%) higher bone density among consumers of 14 or more drinks per week than among abstainers. These relationships were all similar among men and women.
Among older adults, moderate alcohol consumption has a U-shaped relationship with risk of hip fracture, but a graded positive relationship with bone mineral density at the hip.

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    • "Although their primary objective was assessing amount of alcohol consumed, Mukamal et al. also examined beer, wine, and liquor consumption in 5,865 participants in the Cardiovascular Health Study. They included 0 (reference), <1, 1–6, and 7+ drinks per week categories for beer, wine, and liquor and noted that no type was significantly associated with hip fracture [20]. The HR for 1–6 drinks per week of wine was 0.75 (95% CI 0.48-1.17), "
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    • "Proximal femur fractures have been acknowledged as a sign of osteoporosis for more than 150 years (Cooper, 1822). Currently, nearly all hip fractures occur as an outcome of a fall by an individual with reduced bone strength (Melton et al., 2003; Physician&apos;s Guide, 2003; Di Monaco et al., 2006; Mukamal et al., 2007). As such, it is probable that at least some of the described hip fractures are a consequence of bone loss. "
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