The Impact of Smoking on Bone Metabolism,Bone Mineral Density and Vertebral Fractures in Postmenopausal Women |
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| Affiliation: | 1. Department of Medicine (DIMED), Geriatrics Division, University of Padua, Padua, Italy;2. Department of Medicine, ClinicaMedica 1, University of Padua and Regional Centre for Osteoporosis, Padua, Italy;3. National Research Council, Neuroscience Institute, Padua, Italy;1. Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands;2. Department of Surgery, VieCuri Medical Centre, Venlo, the Netherlands;3. NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands;4. Department of Internal Medicine, Subdivision of Endocrinology, VieCuri Medical Centre, Venlo, the Netherlands;5. Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands;6. Department of Orthopaedic Surgery, Research School CAPHRI, Maastricht University Medical Centre, Maastricht, the Netherlands;7. Faculty of Medicine, Hasselt University, Belgium;8. Department of Orthopaedic Surgery, VieCuri Medical Centre, Venlo, the Netherlands;9. Department of Surgery and Trauma Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands;1. Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA;2. Department of Physical Therapy, University of Alabama, Birmingham, AL, USA;3. Department of Kinesiology, University of Georgia, Athens, GA, USA;4. Department of Orthopedics, Nemours AI duPont Hospital for Children, Wilmington, DE, USA;1. Department of Rehabilitation, Dankook University Hospital, Cheonan, South Korea;2. Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Jinju, South Korea;1. Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil;2. Department of Preventive Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil |
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| Abstract: | ![]()
Background: Smoking is recognized among the risk factors for osteoporosis, but only few studies have comprehensively explored its influence on bone metabolism and strength. We aimed to evaluate smoking effects on calcium-phosphate metabolism, bone mineral density (BMD) and fracture risk in postmenopausal women. Methods: Our sample included 1067 postmenopausal women who arrived to our osteoporosis outpatient clinic. Anamnestic data, smoking habits (categorized as never, former, and current; and by smoking intensity and duration), biochemical parameters, lumbar/femoral BMD, and presence of vertebral fractures were recorded. In a subsample of 357 women, the changes in BMD after a 2-yr follow-up period were also assessed. Results: Current smokers had shorter reproductive age, lower body mass index, and higher prevalence of heavy alcohol consumption than former/never smokers. They also had lower PTH values and weaker linear association between serum vitamin D and parathyroid hormone (current β = −0.11[SE = 0.004]; former β = −0.14[SE = 0.01]; never β = −0.20[SE = 0.003]; p < 0.01 for all). Baseline BMD did not reflect differences based on smoking habits, duration or intensity. However, after 2 years, only current smokers significantly worsened in femural BMD. After adjustment for confounders, the chance of having sustained vertebral fractures at the first evaluation increased by 74% (95% confidence interval:1.07–2.83) in current compared with never smokers, especially among heavy smokers. Conclusions: Smoking may negatively affect bone by inhibiting vitamin D-parathyroid hormone axis, reducing estrogen exposure, promoting risky health behaviors, and accelerating bone loss, especially at the femur. No significant differences were observed in these outcomes among former smokers, suggesting that quitting smoking has beneficial effects on bone health. |
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