Alcohol Intake and Bone Microarchitecture Deterioration in Older Men: The Prospective Structure of Aging Men's Bones (STRAMBO) Study.

BACKGROUND: Data on the link between alcohol intake and prospectively assessed changes in areal bone mineral density (aBMD) are scarce. Our aim was to assess the association of alcohol intake with bone loss and microarchitectural decline prospectively assessed in older men. METHODS: In 818 men aged 60 to 87 years, bone microarchitecture was assessed at the distal radius and distal tibia (XtremeCT; Scanco Medical). Areal aBMD was assessed by dual energy X-ray absorptiometry (Hologic Inc.). Both were assessed at baseline, then after 4 and 8 years. Linear mixed models were adjusted for age, body mass index, bioavailable 17β-estradiol, osteoprotegerin, parathyroid hormone, Creactive protein and for grip strength (radius) or for the lower limb physical function score (tibia). RESULTS: At baseline, aBMD and bone microarchitecture measures did not differ across the classes of alcohol intake. During the follow-up, aBMD decrease did not vary differently across the classes of alcohol intake. Men drinking 16 to 112 g alcohol per week had the slowest bone microarchitecture decline (reference group). At the distal radius, trabecular BMD (Tb.BMD) and number (Tb.N) decreased faster in men consuming <16 g/week and in men drinking >224 g/week vs. the reference group. At the distal tibia, cortical thickness (Ct.Thd), cortical area (Ct.Ar), reaction force, and failure load decreased faster in men consuming <16 g/week and in men drinking >224 g/week versus the reference group. CONCLUSIONS: Moderate alcohol intake is associated with slower bone decline. Very low and higher alcohol intake were associated with faster bone microarchitecture deterioration in older men when assessed prospectively.