Alcoholism has marked effects on bone health in middle-aged women, a New Zealand study has shown.

Professor Elaine Dennison, from the Victoria University of Wellington, and her colleagues recruited 41 women with a mean age of 39 who were entering a detox unit, following average alcohol consumption of 18 units a day.

A heel ultrasound Z-score was used to estimate BMD, given the logistical difficulties of asking them to return for a DEXA assessment. The mean was -0.68 compared to +0.44 in 50 healthy controls whose intake averaged just one drink a day.

The women with alcoholism had a higher dietary calcium intake and slightly higher BMI. They were much more likely to be smokers (76% vs 14%), and to be physically inactive (42% vs 2%).

In addition, 71% remembered having a fall in the last year compared to only 10% of controls and they were much more likely to have had a fracture as an adult (44% vs 12%).

P1NP, a marker of bone formation, increased significantly during the five-day detox program, but there was no change in CTX, a marker of bone degradation.

“Most information on the links between alcoholism and osteoporosis is from men, but it has clearly shown that excessive alcohol consumption is an independent risk factor,” Professor Dennison said.

 “In women, the association could be explained by a range of factors including secondary amenorrhoea, poor diet, smoking, lack of exercise, and perhaps lower peak bone mass in women who start drinking when they are very young.

“We confirmed that risk factors for fracture are common in female alcoholics, and that bone formation is increased significantly after alcohol withdrawal.”