No Association Between Alcohol Use, Bone Density in People Living with HIV.
People living with HIV commonly have low bone mineral density and a high risk for fracture. Although alcohol use is also common among people living with HIV and is known to affect bone health, how alcohol use affects bone density in this population is not well understood.
Now, a new study led by a School of Public Health researcher has found no significant association between alcohol consumption and changes in bone mineral density in people living with HIV who also have substance use disorders.
The study was published in Alcoholism: Clinical and Experimental Research.
“We were surprised that heavy drinking did not seem to lower bone density,” says lead author Richard Saitz, professor of community health sciences. “But that probably doesn’t mean that alcohol has no effect. It is more likely that we just were not able to tease out the effects of heavy drinking from other major risks for bone loss in this population with many other factors that can cause it.”
Fractures are substantial causes of morbidity and mortality in older people and are becoming more relevant to people living with HIV (PLWH) as they age. Low bone mineral density (BMD) is common among older PLWH, and they are at high risk for further decline based on many factors, including use of substances like alcohol and other drugs, comorbidities, and medications.
The researchers followed 250 PLWH with substance use disorders for 3.5 years. They measured annual drug use, change in BMD, and the incidence of fractures. At entry into the study, 67 percent of patients had low BMD (46 percent low bone mass, 21 percent osteoporosis).
The researchers found no association between any measure of alcohol consumption and changes in BMD at the femoral neck, hip, or lumbar spine. They also found no association between alcohol consumption and incident fractures.
The investigators emphasized the need for further research to assess the effects of multiple risk factors including alcohol and drug use, comorbidities, and medications on the population of PLWH who are reaching older age now because of the success of HIV treatments.
“Health consequences are often not about single risk factors or exposures; in this case, low bone mass and fracture risks are high among people with HIV infection and substance use disorder, and alcohol is clearly an important risk for those,” says Saitz. “But alcohol use combined with medications, other drug use, and other diseases likely increase risks for health problems that accompany aging.”
Other SPH co-authors included research assistant Aldina Mesic; Michael Winter, associate director of the Biostatistics and Epidemiology Data Analytics Center; Timothy Heeren, professor of biostatistics; Gregory Patts, statistical analyst in the Biostatistics and Epidemiology Data Analytics Center; Seville Meli, director of research operations in the community health sciences department; and Jeffrey Samet, professor of community health sciences.
—Salma Abdalla