Abstract
We aimed to determine the contribution of high alcohol intake to fracture probability, calculated using a fracture-risk assessment tool (FRAX). Participants were 262 men (ages 60–90 y) in the Geelong Osteoporosis Study. Alcohol consumption was documented via a food frequency questionnaire; 46 (17.6%) consumed three or more units per day, fulfilling the criterion for high alcohol intake. Bone mineral density (BMD) was measured by dual energy x-ray absorptiometry. We determined FRAX probabilities (%) for major osteoporotic fracture (MOF) and hip fracture (HF), calculated with and without alcohol intake. Thresholds for high FRAX probabilities, calculated with or without BMD, were ≥20% for MOF and ≥3% for HF. Proportions of men with high HF-FRAX probabilities were consistently greater for drinkers compared with non-drinkers. For drinkers, paired differences showed that median MOF-FRAXwithoutBMD probabilities calculated with and without alcohol changed by −2.3, HF-FRAXwithoutBMD by −1.7, MOF-FRAXwithBMD by −1.4, and HF-FRAXwithBMD by −0.9 (all p < 0.001). We estimated that, should drinkers lower their alcohol consumption to <3 units/d, up to 66.7% of those at high risk for MOF and up to 41.0% at high risk for HF would reduce their FRAX probabilities to below the thresholds for high fracture risk. In the context of the Australian environment, these data describe the extent to which older men with high alcohol consumption are at increased risk for fracture.
Highlights
The University of Sheffield in the United Kingdom developed the FRAX algorithm to estimate absolute fracture risk from the combination of several clinical risk factors [1]
The FRAX algorithm provides a calculated estimate for a 10-year probability of major osteoporotic fracture (MOF; including hip, spine, forearm, and proximal humerus fractures) and hip fracture (HF) by integrating up to eleven clinical risk factors, namely age, sex, weight, height, previous fracture, parental hip fracture, smoking, glucocorticoid use, rheumatoid arthritis, secondary osteoporosis, alcohol consumption, and bone mineral density (BMD) at the femoral neck
We aimed to determine the contribution of high alcohol consumption to increased risk for MOF and HF for older men residing in Australia
Summary
The University of Sheffield in the United Kingdom developed the FRAX algorithm to estimate absolute fracture risk from the combination of several clinical risk factors [1]. The FRAX algorithm provides a calculated estimate for a 10-year probability of major osteoporotic fracture (MOF; including hip, spine, forearm, and proximal humerus fractures) and hip fracture (HF) by integrating up to eleven clinical risk factors, namely age, sex, weight, height, previous fracture, parental hip fracture, smoking, glucocorticoid use, rheumatoid arthritis, secondary osteoporosis, alcohol consumption, and bone mineral density (BMD) at the femoral neck. Moderate to heavy alcohol consumption can displace dietary nutrients important for bone health [8] and is associated with accumulation of visceral fat [9], lower levels of vitamin D [10], and increased risk for falls and fall-related fractures [11,12].
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