Impaired Bone Quality Induced by Methamphetamine

Use in Young Men

Yubing Xu

1,2,†

, Mu Wang

1,2,†

, Yanyan Chen

1,*

, Siyun Shi

, Xianjun Yang

, and Yining Sun

Hefei Institute of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, China

University of Science and Technology of China, Hefei 230026, China

Anhui Medical College, China

Women Specific Drug Rehabilitation Center, Hefei, Anhui, China

Keywords: Bone Quality, BMI, Methamphetamine.

Abstract: Objectives: This study was to investigate the bone quality in young men with long-term methamphetamine

use history and its determinants, compared with age matched normal ones. Methods: 111 males, who had the

history of long-term methamphetamine consumption, and 125 non-drug dependences were recruited as

normal control. Bone quality was tested and collected from participants by a quantitative ultrasound scan

device. Independent t test and multivariate regression model were used to do data analysis. Results: The mean

stiffness-index of individuals with methamphetamine use history was 88.25 (16.04), which was significantly

lower than that of normal ones, 100.02 (23.86), p<0.05. In multivariate regression model, Body mass index

(BMI) and smoking years were positively correlated with bone quality and fat mass was negatively did,

p<0.05. Conclusion: Young men with methamphetamine use history had abnormally low bone quality

compared with individuals with non-drug use history. In addition, their bone health may be also affected by

smoking and overweight or underweight. This special population may be in the risk of bone loss and of

fracture.

1 INTRODUCTION

Peak bone mass is the greatest amount of bone tissue

that individuals can obtain in their life time.

Normally, people reach their peak bone mass around

30 years old (Bonjour, 2009), and then it might be

decreasing with aging (Bonjour, 2009; Hendrickx,

2015; Vashishth, 2005). Higher peak bone mass

would decrease the risk of osteoporosis later in life

(Nalla, 2004). High peak bone mass in young age can

benefit bone health in later years.

Methamphetamine (MA) addiction has become a

worldwide issue and, in some regions, it was

considered as one of the most worry threats of drug

abuse (World Drug Report 2018). Previous studies

reported that MA is associated with neurological and

Corresponding Author, Address: Hubin Building, Science

Island, Shushan, Hefei, Anhui, 230000, China

Tel: 86-13965136021

†

These authors contributed equally to this work, they share

the first authorship. Authors contributed equally to this

study

cardiovascular diseases (Cruickshank, 2009;

Tolliver, 2012) and growing violent behaviors

(McKetin, 2014). This substance has not been

directly linked with bone health, but some other drugs

do. Gotthardt et al. and Ding et al. state that long-term

opioid dependences are more likely to have low bone

mass (Gotthardt, 2017; Ding, 2017). Gozashti et al.

reported that opium use may be risk factor for bone

quality (Gozashti, 2011).

Body composition is associated with bone health.

Fat mass (FM), low body weight (BW) and low fat-

free mass (FFM) are reported as the risk factors of

low bone quality (Lima, 2009; Morin, 2008).

However, this correlation has not been tested in MA-

dependences. Taken together, MA use has not been

researched in bone field and the determinants or risk

factors of MA-dependences’ bone health were not

Xu, Y., Wang, M., Chen, Y., Shi, S., Yang, X. and Sun, Y.

Impaired Bone Quality Induced by Methamphetamine Use in Young Men.

DOI: 10.5220/0012041900003620

In Proceedings of the 4th International Conference on Economic Management and Model Engineering (ICEMME 2022), pages 683-687

ISBN: 978-989-758-636-1

 2023 by SCITEPRESS – Science and Technology Publications, Lda. Under CC license (CC BY-NC-ND 4.0)

683

clear as well. Thus, this study was to investigate the

bone quality in young MA-dependent men and to

analyze the determinants of bone quality.

2 MATERIALS AND METHODS

This study was approved by local Ethic Committee.

Every participant in this study was informed about

the content of this study by written consent prior the

assessments and they had right to reject any of them.

2.1 Participants

Both young men with meth use history and normal

ones were recruited from the middle area of China.

150 MA-dependent men, aged from 23 to 43, were

recruited from Men Specific Drug Rehabilitation

Center, Hefei, Anhui, China. Normal males, aged

from 24 to 42, were recruited from Hefei, Anhui. The

exclusion criteria were 1.) HIV infection; 2.)

fractures in last 12 months; 3.) type 1 diabetes; 4.)

significantly impaired renal or hepatic function, or

chronic kidney diseases; 5.) in acute detoxification;

6.) abstinent time was more than three months; 7.)

polydrug use.

After the exclusion, there were 111 participants

left in the patient group and 125 in control group. In

addition, 46 patients provided their information of

history of drug use, including the duration of MA use

(years), the frequency of MA use (times per week)

and withdrawal time (weeks). Other background

information included smoking time (years) and

drinking (times per week).

2.2 Measurements

All participants accepted bone quality assessment,

which was tested by a quantitative ultrasound scan

(QUS) device. Speed of sound (SOS; m/s) and

broadband ultrasound attenuation (BUA; dB/MHz)

were measured on the right calcaneus of the

participants in an upright seated position.

QUS, an alternative of Dual Energy X-ray

Absorptiometry, can provide structural information

(Njeh, 1997). It expresses bone strength as bone

quality, rather than density or content of bone

minerals (Holi, 2005). QUS is considered as an

accurate technique to show the bone strength and the

risk of fracture (Marín, 2006; Knapp, 2001; Miller,

2002). Stiffness-index (STI) shows the bone strength

and is calculated through the formula:

STI = 0.67 × ‘BUA’ + 0.28 × ‘SOS’– 420 (Njeh,

1997; Holi, 2005)

Higher STI value represents stronger bone

strength. In addition, another indicator T-score,

which is based on STI and calculated in the QUS

device, was used to distinguish osteoporosis or

osteopenia from the normal. The Object will be

classified into the normal, when T-score is more than

−1.0, and put into the osteopenia, when T-score is

between −2.5 and −1.0. If T-score was less than -2.5,

the individual will be osteoporosis.

In addition, there were height, BW, FFM, and FM

assessments. Body height (BH) tested by stadiometer

and the others were measured by bioelectrical

impedance analyzer. Participants were standing on

bare feet with the heel and toe of each foot in contact

with the metal footpads, with arms hanging on each

side, lightly holding the analyzer handgrips.

Coefficient of variance (CV) of the impedance

measure was 0.4%. The values were supported by

skinfold measurements, through harpenden calipers.

2.3 Analysis

This study utilized a confidence interval of 95%.

Independent t test was to compare the differences

between two groups. Multivariate regression model

was used to analyze the correlation between STI and

each factor. The mean value and standard deviation

(SD) are shown as mean (SD) in this paper. In this

study, the result will be considered as significant, if p

value is less than 0.05. All results were performed by

SPSS (version 25).

3 RESULTS

Table 1 shows the background information of control

and patient groups and the drug using history of

patient group. Control group’s STI, BUA and SOS

were 100.02 (23.86), 50.95 (6.07) and 1584.44

(145.84), respectively, which were significantly

higher them of patient group, 88.25 (16.04), 48.31

(5.29) and 1566.39 (149.84), respectively.

The percentage of osteoporosis and osteopenia

was demonstrated in Table 2. Around 32%

participants had osteoporosis or osteopenia in control

group, but around 55% in patient group.

Table 3 demonstrates the relationship between

bone quality (STI) and risk factors. In multivariate

regression model, smoking and FM had significantly

negative correlation with STI and the standard beta

was -0.41 and -1.04, respectively, p<0.05. BMI was

positive correlated with STI, standard beta=1.28,

p<0.01. Other factors did not show significant

association with bone quality.

ICEMME 2022 - The International Conference on Economic Management and Model Engineering

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Table 1: Background information of participants.

Control Group (mean SD) Patient Group (mean SD)

Age 32.30(6.23) 31.84(5.90)

Withdrawal time (weeks) - 4.91(1.60)

Duration of MA consumption (years) (n=46) - 7.13(3.83)

High frequency of MA use a(n=46) - 56%

Drinking 31% 36%

Smoking 38% 91%

Body height (cm) 173.20(16.31) 172.94(17.00)

Body weight (kg) 74.34(13.85) 76.61(11.96)

Body mass index (kg/m2) 24.74(4.29) 25.63(3.98)

Fat Free mass (kg) 59.66(8.76) 61.97(8.13)

Fat mass (kg) 14.70(8.32) 14.67(5.01)

Muscle (kg) 56.64(8.32) 58.84(7.73)

STI 100.02(23.86) 88.25(16.04)

BUA 50.95(6.07) 48.31(5.29)

SOS 1584.44(145.84) 1566.39(149.84)

Table 2: The percentage of osteoporosis and osteopenia.

Bone quality T-Score % of the Controls (n=125) % of the Patients (n=111)

Osteoporosis < =−2.5 1.60% (2) 0.90% (1)

Osteopenia <−1.0 and>−2.5 30.40% (38) 54.96% (61)

Normal samples > =−1.0 68.00% (85) 44.14% (49)

Table 3: Multivariate regression model in patient group.

Factors standard Beta t p value

Constant 2.256 0.030

BMI 1.281 3.074 0.004

Fat free mass -0.288 -1.372 0.178

Fat mass -1.044 -2.740 0.009

Duration of MA use(years) 0.055 0.302 0.764

Frequency of MA use (times per week) 0.044 0.291 0.772

Duration of smoking (years) -0.408 -2.112 0.042

Drinking (times per week) -0.135 -0.817 0.419

Age -0.184 -1.201 0.238

MA: methamphetamine

Impaired Bone Quality Induced by Methamphetamine Use in Young Men

685

4 DISCUSSION

4.1 Main Finding

This study assessed 111 young MA-dependent men’s

bone quality and anthropometric characteristics and

compared them with 125 normal people. MA-

dependent men, whose abstinent time was no more

than three months, had significantly lower bone

quality than normal individuals. BMI, FM and

smoking may also affect the bone quality of MA-

dependent men.

Young MA-dependent men, average aged 32,

should have reached the peak bone quality. However,

their bone quality was in an unhealthy state, which

also reflected on the higher percentage of osteopenia.

The results indicated that their bone quality was

affected by MA use. Bone health has not been

researched on MA-dependent men by previous

studies. Some of them investigated on other drugs.

Gotthardt et al. reported the bone loss in opioid-

dependences, and 29.2% objects were osteoporosis

and 48.1% were osteopenia (Gotthardt, 2017).

Gozashti et al. claim that men with opium use history

are more susceptible to bone loss (Gozashti, 2011).

The possible explanation of the abnormally low bone

quality in MA-dependences would be the hormone

disorders. The disordered hormone may change the

speed of the absorption of bone minerals, calcium,

magnesium and phosphorus, from bone to other

organs, such as kidney (Deftos, 1998; Blaine, 2015).

The faster absorption may result in bone loss.

Gotthardt et al. reported that bone loss in opioid-

dependences may be partially caused by the

deficiency of androgen (Gotthardt, 2017).

Smoking would contribute to bone loss in MA-

dependences. In this study, the duration of smoking

time was negatively correlated with bone quality. The

longer smoking years may have lower bone quality.

Previous studies have not reported the effect of

smoking on drug-dependences’ bone health.

Smoking can affect the metabolism of bones (Yoon,

2012) and decrease the intestinal calcium absorption

(Krall, 1999).

Body composition was correlated with bone

health in MA-dependences. BMI was positively

correlated with bone quality, but FM was negatively.

In normal individuals, both overweight/ obesity and

underweight can result in bone loss. Paniagua et al.

claim that overweight/ obese men are more likely to

have osteoporosis (Paniagua, 2006). Low BMI is also

considered as a risk factor of bone loss (Morin, 2008;

Ravn, 1999).

4.2 Limitation and Further Study

Considering the difficulty of sample recruitment and

assessment, this study did not use global gold

standard, Dual Energy X-ray Absorptiometry.

4.3 Conclusion

In young age, male individuals should grow their

bone mass and reach the peak in life time. However,

long-term MA use might undermine their bone

quality. Young MA-dependent men had lower bone

quality and higher prevalence of osteopenia than the

age matched non-drug dependences. Weight change

was associated with bone health and smoking was

also a risk factor of bone loss in MA-dependent men.

Early screening and treatment for bone loss in this

special group should be considered.

FUNDINGS

This study was supported by

1. Major Science and Technology Project of

Anhui Province (202103a07020004)

2. R&D and demonstration application of self-

service smart health hut based on cloud-edge

collaboration

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