Evidence for defective osteoblastic function. A role for alcohol and tobacco consumption in osteoporosis in middle-aged men.

In a group of 11 men ranging in age from 35 to 50 years with idiopathic osteoporosis, most were mild alcoholics and heavy smokers. Two had absorptive hypercalciuria. Histomorphometry showed that the patients had low trabecular bone volume and mean trabecular thickness when compared with age-matched control subjects. Mean wall thickness was also markedly reduced in patients as compared with control subjects. The quantity of resorbed bone was extrapolated from the calculated mean interstitial bone thickness. Resorption was not significantly different in patients and control subjects. Consequently, in this group of patients with severe osteoporosis, the pathogenesis was characterized by markedly decreased bone formation.