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. 2021 Aug 25;13(9):2955.
doi: 10.3390/nu13092955.

High Alcohol Intake in Older Men and the Probability of Osteoporotic Fracture According to the FRAX Algorithm

Julie A Pasco  1   2   3 , Kara B Anderson  1 , Natalie K Hyde  1 , Lana J Williams  1 , Pamela Rufus-Membere  1 , Kara L Holloway-Kew  1
Affiliations

High Alcohol Intake in Older Men and the Probability of Osteoporotic Fracture According to the FRAX Algorithm

Julie A Pasco et al. Nutrients. .

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.

Keywords: FRAX algorithm; alcohol; bone fragility; fracture risk; injury; major osteoporotic fracture.

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Conflict of interest statement

J.A.P. has received funding from the NHMRC, the Medical Research Future Fund (MRFF) Australia, Barwon Health, Deakin University, Amgen, the Prolia BCGP Competitive Grant Program, Amgen Investigator Sponsored Studies Grant, Amgen Australia, the BUPA Foundation, Osteoporosis Australia, Australian and New Zealand Bone and Mineral Society, the Geelong Community Foundation, the Western Alliance, and the Norman Beischer Medical Research Foundation. K.B.A. is supported by an Australian Government Research Training Program Scholarship; N.K.H. was supported by a Dean’s Research Postdoctoral Fellowship (Deakin University). L.J.W. was supported by a NHMRC Emerging Leadership Fellowship (1174060). She has received funding from Eli Lilly, Pfizer, The University of Melbourne, Deakin University, and the NHMRC. P.R.-M. was supported by an Australian Government Research Training Program Scholarship. K.L.H.-K. was supported by an Alfred Deakin Postdoctoral Research Fellowship and has received funding from the Prolia BCGP Competitive Grant Program and Amgen Investigator Sponsored Studies Grant and Deakin University. The subject matter of this paper will not have any direct bearing on that work, nor has that activity exerted any influence on this project. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Boxplots for FRAX probabilities calculated with and without bone mineral density (BMD) for major osteoporotic fractures (MOF) and hip fractures (HF). Data are shown for alcohol drinkers (alcohol ≥ 3 units/d) and non-drinkers (alcohol < 3 units/d) and by age category.
See this image and copyright information in PMC

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