Association between alcohol consumption, smoking and bone tissue quality in Slovak young adults assessed by radial quantitative ultrasound

Background Despite well-characterised effects of smoking and alcohol on bone health in older adults, evidence remains limited regarding their impact on bone quality during peak bone mass acquisition in young adults (18–30 years). Objectives Analysing the relationship between bone quality, alcohol consumption and smoking, considering physical activity (PA) and body composition. Sample and methods The sample consisted of 1001 Slovak men and women aged 18–30 years (mean age, 22±2.35 years). Bone quality was measured using a quantitative ultrasound device (Sunlight MiniOmni™), which yielded Z-score data. Body composition variables, including skeletal muscle mass (SMM; kg) and per cent body fat (PBF; %), were assessed using a bioimpedance analyser (InBody 770). Additional behavioural factors, including alcohol consumption, smoking and PA, were collected using the WHO STEPS 2014 questionnaire. Results In the regression analysis, duration of alcohol consumption positively predicted bone quality Z-scores (standardised 𝛽 = 0.172, 95% CI [0.03, 0.10], 𝑝 < 0.001), while cigarette smoking quantity was negatively associated (standardised 𝛽 = −0.113, 95% CI [−0.01,−0.00], 𝑝 = 0.042). The SNHA confirmed the findings of the previous analysis concerning alcohol (𝑟=0.19). Conversely, for smoking (𝑟=0.23), it identified an inverse relationship, noting a positive effect on bone health, a finding likely mediated by the association with alcohol consumption. Conclusion Lifestyle risk factors, including smoking and alcohol consumption, are associated with bone tissue quality in young adults; however, due to the mixed results available in the literature and in our study, future studies are required.