Article :: Early smoking is associated with peak bone mass and prevalent fractures in young healthy men

Home > Current Issue > Article

Original Article

Early smoking is associated with peak bone mass and prevalent fractures in young, healthy men

Youri Taes^{1 *}, Bruno Lapauw^{1 2}, Griet Vanbillemont¹, Veerle Bogaert¹, Dirk De Bacquer³, Stefan Goemaere², Hans Zmierczak², Jean-Marc Kaufman^{1 2}

¹Department of Endocrinology, Ghent University Hospital, Belgium
²Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Belgium
³Department of Public Health, Ghent University, Belgium

email: Youri Taes (Youri.Taes@ugent.be)

^*Correspondence to Youri Taes, Department of Endocrinology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.

Keywords

smoking estrogens peak bone mass osteoporosis androgens

Abstract

Smoking is associated with lower areal bone mineral density (aBMD) and higher fracture risk, although most evidence has been derived from studies in elderly subjects. This study investigates smoking habits in relation to areal and volumetric bone parameters and fracture prevalence in young, healthy males at peak bone mass. Healthy male siblings (n = 677) at the age of peak bone mass (25 to 45 years) were recruited in a cross-sectional population-based study. Trabecular and cortical bone parameters of the radius and cortical bone parameters of the tibia were assessed using peripheral quantitative computed tomography (pQCT). Areal bone mass was determined using dual energy X-ray absorptiometry (DXA). Sex steroids and bone markers were determined using immunoassays. Prevalent fractures and smoking habits were assessed using questionnaires. Self-reported fractures were more prevalent in the current and early smokers than in the never smokers (p < .05), with a fracture prevalence odds ratio for early smokers of 1.96 (95% confidence interval 1.18-3.24) after adjustment for age, weight, educational level, and alcohol use and exclusion of childhood fractures. Current smoking was associated with a larger endosteal circumference (

= 0.027 ± 0.009, p = .016) and a decreased cortical thickness (

= -0.034 ± 0.01, p = .020) at the tibia. In particular, early smokers (

16 years) had a high fracture risk and lower areal BMD, together with a lower cortical bone area at the tibia and lower trabecular and cortical bone density at the radius. An interaction between free estradiol and current smoking was observed in statistical models predicting cortical area and thickness (

= 0.29 ± 0.11, p = .01). In conclusion, smoking at a young age is associated with unfavorable bone geometry and density and is associated with increased fracture prevalence, providing arguments for a disturbed acquisition of peak bone mass during puberty by smoking, possibly owing to an interaction with sex steroid action. © 2010 American Society for Bone and Mineral Research

Received: 27 March 2009; Revised: 7 July 2009; Accepted: 30 July 2009

Digital Object Identifier (DOI)

10.1359/jbmr.090809 About DOI